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Darifenacin Repurposing for ALS Treatment Supported by Neuromuscular Junction Research

  • Richard Robitaille, Ph.D., receives the Lalji Award for his research on neuromuscular junction (NMJ) impairments in ALS, leading to a clinical trial.
  • Dr. Robitaille's work showed that Schwann cells do not function properly in ALS, but can be modulated using muscarinic receptor agonists and antagonists.
  • Research indicates a therapeutic window for NMJ reinnervation before motor neuron loss, prompting the repurposing of darifenacin for ALS treatment.
  • Clinical trials are underway to assess darifenacin's efficacy in restoring Schwann cell function and slowing ALS progression, based on promising preclinical results.
Montreal - Richard Robitaille, Ph.D., has been awarded the Drs. Ayeez and Shelena Lalji & Family ALS Endowed Award for Innovative Healing for his groundbreaking research into the mechanisms underlying neuromuscular junction (NMJ) impairments in amyotrophic lateral sclerosis (ALS). His work has paved the way for a clinical trial repurposing darifenacin, an FDA-approved drug, for ALS treatment.
The award was presented at the 35th International Symposium on ALS/MND in Montreal by Merit Cudkowicz, MD, Director of the Sean M. Healey & AMG Center for ALS at Mass General. The Lalji Award recognizes transformative scientific discoveries focused on repairing neurological function in ALS.

Decade-Long Investigation into NMJ Dysfunction

Dr. Robitaille's research has focused on the role of perisynaptic Schwann cells in ALS. His work demonstrated that these cells, which normally support NMJ repair, do not function properly in ALS. Modulation of muscarinic receptors via drug agonists and antagonists can toggle these specialized cells between repair and maintenance mode. His team identified a critical therapeutic window during which NMJs are denervated but motor neurons are not yet lost, offering an opportunity to promote NMJ reinnervation.

Darifenacin: A Potential Therapeutic Agent

This research led to a clinical trial exploring the potential of repurposing darifenacin for ALS treatment. Dr. Robitaille's preclinical studies showed that darifenacin restores the function of Schwann cells in ALS models, significantly impacting disease progression.
"I would like to thank the Lalji family award and the Healey & AMG Center for recognizing our efforts in understanding the impaired mechanisms at neuromuscular synapse in ALS and developing novel neuromuscular-targeted therapeutic strategies that are now tested in the clinic," said Dr. Robitaille.

Significance of the Research

ALS is a progressive neurodegenerative disease affecting motor neurons in the brain and spinal cord, leading to muscle weakness, paralysis, and eventually, death. The disease affects approximately 1 in 50,000 people. Current treatments offer limited benefits, highlighting the urgent need for new therapeutic approaches.
"We are excited to recognize such a deserving individual in the field of ALS research," said Cudkowicz. "Dr. Robitaille exemplifies innovation in care; his willingness to push the boundaries of what is possible in clinical research and understanding this intricate disease is inspiring. We look forward to following his clinical trial."
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Reference News

[1]
Healy Center for ALS Presents the Lalji Award for Innovative Healing
massgeneral.org · Dec 8, 2024

The Sean M. Healey & AMG Center awarded Richard Robitaille, Ph.D., the Drs. Ayeez and Shelena Lalji & Family ALS Endowed...

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