Promising new Parkinson's Disease drug

TriCities.com - Parkinson's patients are hoping a promising new drug will help them get the most out of their current medications. Those medications often bring complications to Parkinson's patients but a non-dopamine drug may be able to help smooth things out.

Terry Bogard's clarinet has been a hobby for years. He's determined that his parkinson's Disease won't rob him of his music.

Terry Bogard said, "gradually, as it's gotten worse, my left hand is less able to, particularly my little finger, operate the keys that they're supposed to."

That's pretty common for patients taking the standard treatment for Parkinson's, Levodopa.

Dr. Robert Hauser said, "the problem is with levodopa it's a medication that gets absorbed, peaks, and is cleared. So we're trying to take a target that we'd like to have nice and smooth and we're usually a bullet that goes up and down to shoot at that target."

When the fluctuations are mild, doctors can move the Levodopa closer together, or add other dopamine medication. but Doctor Hauser is studying a non-dopamine drug to help

Preladenant is in the category called A2A or adenosine 2A inhibitors. And what these medications do is they interact with the dopamine system in the brain but they're unique and different because they're not dopamine.

Terry, who spent his career in clinical research, was happy to travel to take part in Doctor Hauser's study.

Dr. Hauser said, "this drug interacts with that dopamine system past where dopamine does its thing and it tends to move the system back toward normal. So it does have a more prolonged effect uh but it works right now we think in concert with levodopa. So you still have the fluctuations from levodopa but overall it helps smooth out that clinical response."

The Phase 3 study of Preladenant is underway now at multiple sites (find them at http://clinicaltrials.gov/ct2/show/nct01155479).


Doctor Hauser says if all goes well with FDA approval, perhaps as soon as two to three years from now, it will be the first non-dopamine treatment for Parkinson’s Disease.

Promising Developments in Neurotrophic Gene Therapy for Parkinson’s Disease

Promising Developments in Neurotrophic Gene Therapy for Parkinson’s Disease
Raymond Bartus, Ph.D. and Joao Siffert, M.D.
NWPF.org - Ceregene, Inc., a biopharmaceutical company, is progressing with enrollment and dosing in its CERE-120 (AAV2-neurturin) Phase 2b multi-center, placebo (sham)-surgery, double-blinded controlled trial in Parkinson's disease.

The purpose of this Phase 2b study is to evaluate the safety and potential benefits of CERE-120 (AAV2-neurturin) in the treatment of Parkinson's disease. CERE-120 is an experimental biological drug that uses gene transfer technology to deliver human neurturin, a neurotrophic (growth) factor, directly into the brain areas most affected by Parkinson’s disease – the dopamine producing neurons. Similar to other growth factors (such as GDNF), neurturin has been shown in laboratory tests to restore function and protect brain cells from further damage.

CERE-120 has been carefully studied in laboratory animals without any toxicity, even following very high doses. In addition, in animals with neuronal degeneration and motor deficits similar to Parkinson's disease, CERE-120 was shown to protect brain cells and restore their function.

Three clinical studies were then successfully conducted in people with Parkinson’s disease, collectively providing evidence that CERE-120 can generally be delivered safely and may possibly reduce Parkinson’s symptoms (Marks et al., Lancet Neurol, 2008; Marks et al., Lancet Neurol 2010; Siffert et al. Neurology, 2011 (abstract))

This current trial has incorporated knowledge gained from the three previous trials and is intended to more clearly establish benefit of CERE-120, while further supporting its safety (Bartus et al., Mov Disord 2011). This study is actively enrolling participants in 11 centers across the United States. These sites are among the best movement disorders centers in the country and include Baylor College of Medicine (Houston, TX), Beth Israel Medical Center (New York, NY), Columbia University Medical Center (New York, NY), Duke University School of Medicine (Durham, NC), Emory University Hospital (Atlanta, GA), Mount Sinai Medical Center (New York, NY), Rush University Medical Center (Chicago, IL), Stanford University School of Medicine (Palo Alto, CA), University of Alabama (Birmingham, AL), University of California (San Francisco, CA) and University of Pennsylvania Hospital (Philadelphia, PA).

Study participants are randomly assigned (like the flip of a coin) to either receive CERE-120 or undergo a “placebo” (sham) surgery (where minimal surgical intervention occurs and no medication is injected). After the study procedure, participants are followed for approximately 18 months in a double blind fashion and up to 3 years for safety tests. To date, approximately 50% of the 52 subjects have enrolled and many others are in the process of being enrolled. It is anticipated that enrollment will be completed in the fall of 2011.

Once the Phase 2 study is completed (anticipated in early 2013), and if there is a benefit of CERE-120, participants who had a placebo surgery will be offered CERE-120 at no cost and prior to commercial availability of CERE-120.

For more information about the study, log on towww.ceregene.com or call toll free at 1-855-CERE120 (1-855-237-3120)                       

From NorthWest Parkinson Foundation:

Worms leading way in Mac Parkinson’s research thespec.com - McMaster University researchers are looking to an army of tiny worms to lead them to new treatments for Parkinson’s disease. In a highly unusual study, the Mac scientists will take advantage of the serendipitous fact that the tiny worms, called nematodes, and humans share genetic similarities in the brain’s dopamine neurons that are affected by people with Parkinson’s. The project will use researchers fromthe McMaster’s faculties of engineering, sciences and health sciences and is being financed with a $450,000 grant from the Collaborative Health Research Projects program of the National Science and Engineering Research Council and the Canadian Institutes of Health Research. Bhagwati Gupta, a professor in the department of biology, says nematodes are frequently used in medical research, especially in cancer studies, but only now has a way been developed to effectively use them in Parkinson’sdisease studies. Normally, the worms — barely visible to the human eye — are placed in a petri dish and their movements monitored when subjected to various stimuli.things. But Ravi Selvaganapathy, an associate engineering professor and expert in the design, fabrication and development of micro devices, came up with an ingenious micro channel device that restricts the movement of the worms. They can only wiggle forward or backwards, creating a more optimum circumstance for them to be observed and tested. “What we found was their neurological development can be tracked by the speed by which they respond to an electric field,” said Selvaganapathy. “We have a way of telling the worm something to do and it does something in response,” says Selvaganapathy. He says the electrical impulse works like a police officer telling a suspected drunken driver to walk a straight line. The officer decides on the neurological state of the person by the way he walks. In the same way, the movement of the tiny worms is observed to see if they are moving normally or abnormally. Irregularly moving nematodes, which have been modified, can be given various drugs and chemicals to see how they respond. Over the next few years, the McMaster researchers over the next few years will test the effects of more than 500 compounds on nematodes. The research can be done much more quickly and less expensively with the tiny worms than with laboratory rats. Ram Mishra, a professor in the department of psychiatry and neuroscience who studies nervous system degeneration, says the study procedure is very simple but it can answer complicated questions. He hopes that someday, the findings can be used to develop drugs to help humans with Parkinson’s.

29th June 2011 - New research

  MALE  FEMALE DIFFERENCES IN PARKINSON'S DISEASE

Maturitas [2011] Jun 24 [Epub ahead of print] (K.P.Roland, J.M.Jakobi, C.Powell G.R.Jones)

There are clearly more men than women with Parkinson's Disease. In some countries, the ratio of men to women with Parkinson's Disease is more than 2 to 3 times greater. Only in Russia, and to an even greater extent in Japan is Parkinson's Disease clearly more common in women. This may be due to the large number of men who died during warfare, rather than an actual greater prevalence. Men and women also differ in the prevalence of certain types of symptoms. Rigidity, postural instability, and also dyskinesia caused by L-dopa have all been found to be more prevalent in females with Parkinson's Disease. Reports suggest that females with Parkinson's Disease also have different walking patterns compared to males with Parkinson's Disease, and women who do not have Parkinson's Disease. Females with Parkinson's Disease also experience increased freezing when walking when compared to men. Balance is also reduced in females with Parkinson's Disease in comparison to men with Parkinson's Disease.

THE PREVALENCE OF DROOLING IN PARKINSON'S DISEASE

27th June 2011 - New research

THE PREVALENCE OF DROOLING IN PARKINSON'S DISEASE

Journal of Neurology [2011] Jun 23. [Epub ahead of print] (Kalf JG, Bloem BR, Munneke M.)

Drooling as symptom of Parkinson's Disease has so far been poorly defined. This uncertainty is reflected by high variations in published prevalence rates. Drooling is when saliva flows outside the mouth. Drooling is generally caused by excessive production of saliva, inability to retain saliva within the mouth, or problems with swallowing. The aim of this study was to investigate the prevalence of saliva loss and the accumulation of saliva in Parkinson's Disease as an initial stage, and diurnal (daytime) drooling versus nocturnal (nighttime) drooling.

Of those people with Parkinson's Disease, 29% had no complaints at all with saliva control, 43% of them experienced accumulation of saliva or only nocturnal (nighttime) drooling, and 28% had diurnal (daytime) drooling. Most of those that had daytime drooling had nighttime drooling as well. The longer somebody had Parkinson's Disease the more prone they were to nocturnal (nighttime) drooling. Drooling was independently associated with involuntary mouth opening, and swallowing complaints. Diurnal (daytime) drooling typically appeared as Parkinson's Disease got worse.