HYPE?

Media portrayal:

HOPE?

Scientific interpretation:

Exenatide versus placebo: Trial of diabetes drug in Parkinson’s

Original article: Exenatide once weekly versus placebo in Parkinson’s disease: A randomized, double-blind, placebo-controlled trial, The Lancet: August 3, 2017. 

The takeaway

The type 2 diabetes drug Exenatide may have the potential to slow the progression of Parkinson’s disease, according to results from a recent clinical trial. However, additional studies are needed to determine whether it is truly disease-modifying or if its effects are only symptomatic.

Why is it important?

If successful in further clinical trials, Exenatide could be one of the first drugs to actually interfere with the progress of Parkinson’s disease, potentially giving patients more years with reduced symptoms. Although current therapies can help improve symptoms, they typically become less effective over time and side effects become more prevalent.

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IMPACT

  • Novelty 80% 80%
  • Proximity 90% 90%
  • Deliverability 100% 100%

Impact Opinion

“The trial provided additional support for further study of Exenatide and other GLP-1 agonists (a common category of diabetes drugs) for the treatment of Parkinson’s disease. Results from this study as well as previous work is promising; however, more research is needed to fully understand if Exenatide is slowing the disease’s progress.” Dr. Patrik Brundin

Exenatide is already approved to treat diabetes. However, until additional studies are completed, the authors urge caution in adding Exenatide to Parkinson’s disease treatment regimens.

The details

The phase II clinical trial involved 60 people with Parkinson’s. Half of these patients received an injection of Exenatide once a week and half received a placebo for 48 weeks. All participants continued to take their usual medications throughout the trial.

The trial was randomized and double blind, meaning the physicians administering the treatment and the patients didn’t know who received Exenatide and who received the placebo until after the end of the trial. This precaution helps minimize the placebo effect and ensures that the results are analyzed objectively.

Throughout the 48 weeks, physicians closely monitored patients and evaluated their motor and non-motor symptoms. Following this period, the drug and placebo were stopped. Patients were monitored for an additional three months. Following this three month ‘wash out’ period those who had been taking Exenatide had an average advantage of 3 points in the movement aspect of their clinical assessments compared to those on placebo. As an advantage was seen even 3 months after participants had stopped taking the drug, this suggests that Exenatide is potentially slowing the progression of Parkinson’s rather than solely improving the symptoms.

Next steps

A broader phase 3 clinical trial is required to confirm that Exenatide is altering the progression of Parkinson’s and whether this effect accumulative; whether the advantage of those taking Exenatide compared to those on placebo continues year on year.

Related work

Two further phase 2 clinical trials using similar drugs, Liraglutide and Lixisenatide are currently underway. Both these drugs also activate the GLP-1 receptor and are currently used to treat type two diabetes, preclinical evidence has suggested that these drugs may have a more potent and longer lasting effect than Exenatide in models of Parkinson’s.  More information about these trials can be found on the CPT website.

If you are interested in taking part in a clinical trial near you, take a look at Fox Trial Finder.

Original article: Athauda D, Maclagan K, Skene SS, Bajwa-Joseph M, Letchford D, Chowdhury K, Hibbert S, Budnik N, Zampedri, Dickson J, Li Y, Aviles-Olmos I, Warner TT, Limousin P, Lees AJ, Greig NH, Tebbs S, Foltynie T. August 3, 2017. Exenatide once weekly versus placebo in Parkinson’s disease: A randomized, double-blind, placebo-controlled trial

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