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Can a GLP-1 Agonist Improve Parkinson’s Symptoms?

Neurology > > Parkinson’s Disease– A variation of exenatide stopped working a stage II trial, however meant advantages in clients under 60

by Judy George, Deputy Managing Editor, MedPage Today December 19, 2023

An investigational brain-penetrant, pegylated analogue of the glucagon-like peptide-1 (GLP-1) receptor agonist exenatide (Byetta, Bydureon) referred to as NLY01 did not cause enhancement in Parkinson’s illness signs compared to placebo, a stage II trial revealed.

Neither 2.5 mg or 5.0 mg of weekly NLY01 injections revealed any distinction from placebo in the amount of Movement Disorder Society Unified Parkinson’s Disease Rating Scale (MDS-UPDRS) parts II and III ratings at 36 weeks, according to Andrew McGarry, MD, of Rowan University in Camden, New Jersey, and coworkers.

Compared to placebo, the distinction at 36 weeks was -0.39 (95% CI -2.96 to 2.18, P=0.77) for 2.5 mg and 0.6 (-2.28 to 3.00, P=0.79) for 5.0 mg, McGarry and co-authors reported in Lancet Neurology

A subgroup analysis recommended the possibility of motor advantage in individuals under age 60, the scientists stated.

The GLP-1 receptor exists in the brain, and agonist activity is believed to be anti-inflammatory by decreasing microglia activation. Exenatide is a GLP-1 receptor agonist authorized to deal with type 2 diabetes.

“In a database of more than 100,000 people with diabetes, those utilizing GLP-1 receptor agonists had a 62% lower threat of establishing Parkinson’s illness,” McGarry and coworkers mentioned. In 2017, a single-center trial revealed that exenatide had favorable results on Parkinson’s motor ratings that continued beyond the duration of direct exposure.

Individuals with type 2 diabetes have actually an increased danger of Parkinson’s illness, especially those with early diabetes start (ages 25-44) and a low BMI (listed below 18.5), kept in mind Claudia Trenkwalder, MD, and Brit Mollenhauer, MD, of the University Medical Center G├Âttingen in Germany, in an accompanying editorial.

“The Parkinson’s illness course can be quicker and more serious for people with type 2 diabetes than for those without type 2 diabetes, and it can be defined by motor changes in action to treatment taking place earlier and a more fast decrease in cognitive function,” Trenkwalder and Mollenhauer composed.

Trials like the NLY01 stage II research study that examine the preventive capacity of existing drugs are urgently required, the editorialists observed.

“One technique to progress with GLP-1 agonists might be to much better choose the individuals with Parkinson’s illness– e.g., youths with high inflammatory activity who would benefit most from the targeted metabolic and inflammatory system of GLP-1 agonism,” they recommended.

“In addition to thoroughly choosing individuals at a proper illness phase, enhancements to the style of research studies in individuals with recognized Parkinson’s illness requirement to be pursued,” they included.

McGarry and co-authors randomized 255 individuals with early neglected Parkinson’s illness to subcutaneous 2.5 mg or 5.0 mg NLY01, or placebo (85 individuals in each group).

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