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Diabetes drug holds promise to slow Parkinson’s progression

Published on 04/08/17 at 09:22am

There are currently no treatments that are able to slow the development of Parkinson’s disease. This unmet medical need will become increasingly urgent as ageing populations mean that more people will be diagnosed with the condition.

A breakthrough piece of research that has found a repurposed use for a diabetes drug that could slow down the progression of the disease has been welcomed by scientists and charity groups.

The study found that people living with Parkinson’s who injected themselves weekly with exenatide for a year displayed improved motor skills when compared with those who had been receiving placebo treatment.

The patient group was relatively small, with only 60 patients involved, but the treatment seemed to be able to manage the decline associated with Parkinson’s over the course of the study – opening the possibility for studies over a longer period of time.

Participants were measured on a 132-point motor skill scale; those who had taken placebo treatment were found to display a drop of three points on the scale after one year while those taking the treatment gained one point.

The four point different is minor but, as the treatment only lasted one year, it is possible that continual treatment could boast a cumulative impact.

“This is a very promising finding, as the drug holds potential to affect the course of the disease itself, and not merely the symptoms," said the study's senior author, Professor Tom Foltynie, UCL Institute of Neurology. "With existing treatments, we can relieve most of the symptoms for some years, but the disease continues to worsen.”

Current treatments seek to replace the dopamine that is lost, as the bran’s dopamine-producing cells stop functioning. Though dopamine-replacement counteracts symptoms of the disease, it does not do anything to halt disease progression.

How exenatide is able to prevent the decline associated with Parkinson’s is not immediately clear from the study. Recent studies have linked insulin signalling in the brain to neurodegenerative disorders, such as Parkinson’s.

The next step for the drug will be to hold further trials to determine what the exact effect is and if the results can be sustained over a longer period.

"While we are optimistic about the results of our trial, there is more investigation to be done, and it will be a number of years before a new treatment could be approved and ready for use. We also hope to learn why exenatide appears to work better for some patients than for others," cautioned the study's first author, Dr Dilan Athauda, UCL Institute of Neurology.

The drug itself has an interesting history, after being developed from Gila monsters, a venomous lizard native to southwest US and north-west Mexico, and their saliva.

The lizard is notorious for having a painful bite but a hormone in the saliva was isolated by John Eng and was shown to have a glucoregulatory effect. It was later synthesised as a treatment for Type 2 diabetes and approved in 2005. The drug now may find new benefits after this latest research.

Professor David Dexter, Deputy Director of Research at Parkinson's UK, points in the direction that future research may take: "The small benefits seen in this study are particularly promising because only a low level of exenatide actually reached the brain. This suggests that finding treatments that work in a similar way, but are better able to cross from the bloodstream into the brain, may be even more effective.”

Ben Hargreaves

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