Professional conferences are always a whirlwind. Putting faces to names, balancing time between posters and presentations... The few days Maurizio Facheris, MD, MSc, our associate director of research programs and I spent in Philadelphia last week at the American Academy of Neurology meeting — along with a rumored 12,000 other attendees — were no exception.
In no particular order, here are a few takeaways from what we heard:
A study out of Venice, Italy, sponsored by Abbvie Inc., of the company’s intestinal gel form of levodopa (called duodopa) reported 1.7 fewer hours of dyskinesia a day compared to the standard, oral medication. Sleep and fatigue improved, too. This delivery method — already available in Europe, Canada and Australia — has been fast-tracked by the U.S. Food and Drug Administration for review.
- Takeaway: Duodopa may help avoid some dyskinesia, a debilitating side effect of the current gold standard treatment.
Researchers at the University of Iowa compared intervals of increased effort versus continuously moderate exercise training among people with Parkinson’s. They found that interval training is not superior to continuous aerobic activity. Exercise in general was associated with improvements in depression and UPRDS motor symptom score.
- Takeaway: You don’t have to push yourself hard to reap the benefits of exercise on Parkinson’s disease.
MJFF grantee Civitas Therapeutics presented that its “rescue” therapy, an inhaled form of levodopa, reduced daily “off” time by 1.64 hours. This medication is to be used when the effects of oral levodopa wear off before the next allotted dosage time. The Civitas therapy (CVT-301) alleviated motor symptoms 10 minutes after administration.
- Takeaway: This therapy could allow for quick, easy relief from troublesome “off” episodes, improving quality of life.
University of Pennsylvania scientists referenced earlier studies citing that people with higher levels of the protein ApoA1 are less likely to develop Parkinson’s disease, and that PD patients have lower levels of this protein. They will investigate this target further in samples from the Parkinson’s Progression Markers Initiative, the landmark biomarkers study sponsored by MJFF.
- Takeaway: This protein may be useful as a biomarker to monitor Parkinson’s disease and as a target for disease-modifying therapies.
The University of California, Los Angeles is investigating the protective mechanism of isradipine, a calcium channel blocker associated with slower progression of Parkinson’s. They found that this compound could help cells break down toxic species and reduces levels of alpha-synuclein, the protein that clumps in cells of people with PD.
- Takeaway: Understanding how this compound may help prevent or treat Parkinson’s can help researchers refine their approach and maximize its therapeutic potential. Trials of this drug are already underway; isradipine will move into Phase III clinical testing later this year.
Adamas Pharmaceuticals presented results from a clinical study of their extended release capsules of amantadine, a medication used to treat dyskinesia. Time “on” with troublesome dyskinesia was reduced from 4.5 to 1.8 hours per day after eight weeks of treatment compared to placebo. “Off” time was reduced from 4.3 to 3.2 hours a day, and the drug was well tolerated.
- Takeaway: This treatment could become the new standard for treating dyskinesia. It will advance to Phase III testing later this year.
Walter Rocca, MD, of the Mayo Clinic presented some statistics on the global epidemiology of PD: by 2030 there will be 8.7 million people with Parkinson’s in the world. In 2005 there were 4.1 million. He outlined four ways to approach PD: (i) modify risk factors in the entire population: legal regulation of pesticides, changes in diet; (ii) focus on people at high-risk: agricultural occupations, some families; (iii) diagnose and treat early: biomarkers, neuroprotective drugs; and (iv) treat after the onset of Parkinson’s.
- Takeaway: We need to find ways to find people at risk and develop treatments to intervene early. Public policy could also help by eliminating some environmental factors.
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