The concept was so tantalizing. Medicine within the GLP-1 class, which incorporates Wegovy and Ozempic, have proved miraculous in treating weight reduction and different illnesses. And a few researchers hoped that the medication might additionally assist with a number of the most tough illnesses to deal with — these of the mind, like Parkinson’s.
However now, at the very least for Parkinson’s, that hope appears dimmed. A rigorous examine that randomly assigned Parkinson’s sufferers to take exenatide, a relative of Ozempic, confirmed completely no profit or slowing of the course of the degenerative illness after 96 weeks.
And there have been no impact on affected person signs, no impact on mind scans, no subgroup that confirmed any profit. Irrespective of how the researchers sliced the information the outcomes have been the identical.
The examine, printed Tuesday in The Lancet, is dangerous information for the half million Individuals who’ve been recognized with Parkinson’s illness. Signs embrace tremors, stiffness and problem with steadiness. Sufferers additionally might develop dementia. Therapies, together with medicines and deep mind stimulation, may help with signs. However no remedy has been proven to gradual the illness’s progress.
“It’s vastly disappointing,” mentioned Dr. Thomas Foltynie of College School London, who led the trial. “We have been anticipating we might come by way of and we’d get a constructive end result.”
Parkinson’s consultants shared his sentiment.
“This can be a sobering second,” mentioned Dr. Michael S. Okun, a Parkinson’s illness knowledgeable on the College of Florida and the nationwide medical adviser for the Parkinson’s Basis. “This can be a rather well accomplished examine and it got here up empty-handed.”
The discovering might have implications for researchers who’re asking if the newer GLP-1 medication might assist gradual the course of Alzheimer’s or might stop the illness.
The brand new examine concerned 194 individuals with Parkinson’s illness handled at six analysis hospitals within the U.Okay. The sufferers have been randomly assigned to inject themselves as soon as every week for 96 weeks with exenatide, a sort 2 diabetes remedy made by AstraZeneca and offered beneath the model title Byetta, or with a placebo. The trial was funded by Britain’s Nationwide Institute for Well being and Care Analysis with help for substudies from the charity Remedy Parkinson’s and the Van Andel Institute.
The drug is in the identical class as Ozempic and Wegovy and, like them, lowers blood sugar ranges. All are so-called GLP-1 receptor agonists, generally known as GLP-1s. Exenatide shouldn’t be as highly effective in eliciting weight reduction because the newer medication, however consultants say there isn’t any cause to imagine that the newer medication would carry out in a different way in research of mind illness.
The outcomes, researchers mentioned, are particularly disappointing as a result of there have been options that GLP-1 medication would possibly assist Parkinson’s sufferers.
GLP-1 medication protected neurons from harm in laboratory research and in a examine with rats given a mind harm like that in Parkinson’s illness.
It started to appear that the outcomes may also apply to sufferers.
“Individuals began digging into claims databases,” Dr. Okun mentioned, explaining that researchers had examined massive databases exhibiting medication that individuals took and their diagnoses. The researchers requested if sufferers who had taken GLP-1s could be much less prone to get Parkinson’s or, if that they had it, would have a illness that progressed extra slowly.
The outcomes have been promising.
They regarded at epidemiological research. They discovered that individuals with diabetes who took GLP-1s have been much less prone to have Parkinson’s.
Then two small research prompt that exenatide would possibly gradual the development of some Parkinson’s signs over a 12 months’s time.
Persevering with the hints of progress, a bigger however nonetheless preliminary examine, printed final 12 months within the New England Journal of Drugs, discovered {that a} GLP-1 that’s now not in the marketplace — lixisenatide — appeared to barely gradual progress of the illness over a 12 months.
Dr. Okun, on the time, mentioned that the end result was “nibbling on the edges of illness modification.”
“What we had final 12 months was a one-year trial and a small sign,” mentioned Dr. David Standaert, a Parkinson’s researcher on the College of Alabama at Birmingham. “What would occur should you went longer? Properly, that is longer and there’s simply not a lot right here.”
The issue with learning GLP-1s in Parkinson’s illness, Dr. Standaert mentioned, is that what exenatide is meant to be doing within the mind shouldn’t be clear.
“I wouldn’t do one other examine like this except you study what’s the goal,” Dr. Standaert mentioned. “What’s the biochemistry you are attempting to alter within the mind? How do these medication work, anyway?”