Research presented at the 2024 International Congress of Parkinson’s Disease and Movement Disorders (MDS) highlighted advancements in Parkinson's disease (PD) treatment, including device-assisted dopamine therapy, the drug TAK-071, subcutaneous carbidopa/levodopa, adaptive deep brain stimulation (DBS), and an antibody targeting alpha-synuclein.
Device-Assisted Dopamine Therapy
David Devos, MD, PhD, presented data from the phase 1/2 DIVE-I trial, evaluating a device-assisted therapy that delivers dopamine directly to the brain. The study included 12 patients with PD experiencing motor complications. The therapy stabilizes dopamine in an anaerobic environment and administers it via a minimally invasive pump, avoiding side effects associated with oral dopamine treatments. Results demonstrated significant benefits in symptom control without inducing dyskinesia.
TAK-071 for Cognitive Impairment
A Phase 2 clinical trial of TAK-071, an acetylcholine M1 receptor positive allosteric modulator, showed promise in improving cognition in PD patients with cognitive impairment. The randomized, double-blind, placebo-controlled trial assessed the impact of TAK-071 on walking and cognition. While gait parameters did not improve, TAK-071 was generally safe, well-tolerated, and improved cognition compared to placebo.
Subcutaneous Carbidopa/Levodopa
Data from two Phase 3 trials, encompassing 385 PD patients, were analyzed to assess the impact of subcutaneous carbidopa/levodopa. Results indicated improved motor function, daily activities, sleep, and quality of life compared to oral carbidopa/levodopa. This subcutaneous formulation is poised to become available for patients soon, offering an alternative for those experiencing ON and OFF times.
Adaptive Deep Brain Stimulation (DBS)
In a pilot study, 15 patients with PD were implanted with electrodes capable of adaptive DBS. Patients underwent two study phases: a two-day experimental session comparing adaptive and conventional DBS, and a one-month follow-up phase at home. Although motor scores were similar between the two modes, 90% of patients preferred adaptive DBS, suggesting it may become the standard of care. Adaptive DBS adjusts electrical stimulation parameters based on the brain's electrical signals, optimizing the effects of DBS.
Antibody Targeting Alpha-Synuclein
An open-label extension of the PASADENA trial studied the effect of prasinezumab, an antibody against alpha-synuclein, on motor progression in PD. The initial trial with 316 participants did not meet its primary endpoints but showed a statistically significant difference in the Movement Disorder Society-Unified Parkinson Disease Rating Scale (MDS-UPDRS) Part III. The extension study demonstrated a slower decline in MDS-UPDRS Part III scores in those who received the antibody compared to an external control group, suggesting the antibody may slow motor progression in PD.
Cell-Based Therapy
NouvNeu001, a dopaminergic-precursor cell therapy derived from induced pluripotent stem cells (IPSCs), was tested in a person with PD for the first time, demonstrating good safety and tolerability and improvement in motor scores. This is an early-stage research development for PD.
