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Motor and Cognitive Advantages Persist 12 Months After Exenatide Exposure in Parkinson’s Disease

Article type: Research Article

Authors: Aviles-Olmos, Iciara | Dickson, Johnb | Kefalopoulou, Zinoviaa | Djamshidian, Atbinc | Kahan, Joshuaa | Ell, Peterb | Whitton, Peterd | Wyse, Richarde | Isaacs, Tome | Lees, Andrewc | Limousin, Patriciaa | Foltynie, Thomasa; *

Affiliations: [a] Sobell Department of Motor Neuroscience, UCL Institute of Neurology, London, UK | [b] Department of Nuclear Medicine, University College London Hospitals NHS Trust, London, UK | [c] Reta Lila Weston Laboratories, London, UK | [d] UCL School of Pharmacy, London, UK | [e] The Cure Parkinson’s Trust, St. Botolph’s, London, UK

Correspondence: [*] Correspondence to: Tom Foltynie, Box 146, National Hospital for Neurology & Neurosurgery, Queen Square, WC1N 3BG, London. Tel.: +44 (0) 203 448 8726; Fax: +44 (0) 203 448 0142; E-mail: [email protected]

Keywords: Parkinson’s disease, clinical trial, disease modifying treatment, UPDRS, exenatide, diabetes mellitus

DOI: 10.3233/JPD-140364

Journal: Journal of Parkinson's Disease, vol. 4, no. 3, pp. 337-344, 2014

Published: 2014
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Abstract

Background: Data from an open label randomised controlled trial have suggested possible advantages on both motor and non-motor measures in patients with Parkinson’s disease following 12 months exposure to exenatide.

Objective: Continued follow up of these same patients was performed to investigate whether these possible advantages persisted in the prolonged absence of this medication.

Methods: All participants from an open label, randomised controlled trial of exenatide as a treatment for Parkinson’s disease, were invited for a further follow up assessment at the UCL Institute of Neurology. This visit included all 20 individuals who had previously completed twelve months exposure to exenatide 10ug bd and the 24 individuals who had acted as randomised controls. Motor severity of PD was compared after overnight withdrawal of conventional PD medication using blinded video assessment of the MDS-UPDRS, together with several non-motor tests. This assessment was thus 24 months after their original baseline visit, i.e. 12 months after cessation of exenatide.

Results: Compared to the control group of patients, patients previously exposed to exenatide had an advantage of 5.6 points (95% CI, 2.2–9.0; p = 0.002) using blinded video rating of the MDS-UPDRS part 3 motor subscale. There was also a difference of 5.3 points; (95% CI, 9.3–1.4; p = 0.006) between the 2 groups on the Mattis Dementia Rating scale.

Conclusions: While these data must still not be interpreted as evidence of neuroprotection, they nevertheless provide strong encouragement for the further study of this drug as a potential disease modifying agent in Parkinson’s disease.

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