Exanatide


#1
http://www.parkinsons.org.uk/about_us/news/news_items/all_news/diabetes_drug_trial_results.aspx

The results are promising. There are some things I am wondering about:

- I wonder whether a brain scan revealed that exanatide saved and/or regenerated neurons.

- There was also this 1 person that had interference with his meds. I wonder which meds he was taking.

- When will clinical phase II start ?

#2
More info

http://www.jci.org/articles/view/68295?key=424690bda975bb0c7d68

#3
Question to research team: Has exanatide also been tested on mice with genetic forms of PD or with misfolded a-synuclein in their brain ?

#4
The authors caution there was no placebo control group for cost and practical reasons they give......people getting injections of saline instead of Exanatide. The placebo effect can be substantial.........

#5
Some of you may be interested in thefull report which can be accessed through this page.
http://www.cureparkinsons.org.uk/News/exenatide


The funders of the research put out this press release ; I have just received It and hope it OK tp post here. Hope something comes of this one but we will have to wait.... As usual.



The Cure Parkinson's Trust is delighted that the Exenatide (Exendin) study results have been published in the Journal of Clinical Investigation. The study was funded by The Cure Parkinson's Trust and took place at UCL in London.

"There are three exciting thing about these results:

1. If future and larger studies on this drug prove the outcome of this trial, then because of its status as a diabetes type 2 treatment, its use in Parkinson’s could be dramatically accelerated. It is possible that this therapy could be available to people with Parkinson’s within a matter of a few years.

2. These results suggest that the drug is safe and well tolerated by people with Parkinson’s and that it may have a beneficial effect on both motor and non-motor symptoms.

3. Scientific experts who have analysed these results say that the trial not only 'speak in favour of a disease-modifying effect' but also they recognise the nature and scale of this trial as a cost effective, quicker and more practical method of screening new molecules for use in Parkinson’s.

#6
Hi Mister X,

Thanks for your question. I've passed it to the Research team. Claire is out of the office today but we'll post an answer as soon as we can.

Ezinda

#7
Apologies, in my haste i repeated a link others had given, one reason it happened was not being able to see what others had written as I was replying, roll on new forum!

#8
hikoi

i think one of the very encouraging aspects of recent events is that researchers are saying there will be something in at most 3-4 years whereas they used to say it will be at least 5 to 10 years. things are being fast tracked - its almost a competition to see who is going to win the big prizes. personally i am very optimistic.

#9
Hello everyone

Sorry for the slight delay in joining the conversation.

To answer your questions Mister X:

No, I'm not aware of any studies which have tested exenatide in genetic animal models of Parkinson's. I believe all the pre-clinical research to date has used toxin based models.

Most of this early work has been carried out by Dr Peter Whitton and funded by Parkinson's UK. You can read more about his work here:

http://bit.ly/18hxXzf

The results from the brain scans were inconclusive overall. From the paper:

"All exenatide group patients had profoundly abnormal scans at baseline, with some variation in severity of presynaptic dopaminergic deficit. 2 patients with severe baseline presynaptic deficits had minor improvement at 12 months. 1 individual had deterioration in all subregions. Mean values for absolute and percent changes in [123I]FP-CIT activity showed minimal change in all basal ganglia subregions in the exenatide group at 12 months."


Three people dropped out of the trial in total. One because of interference with their medication - the medication was not specified but exenatide slows stomach emptying so the team believe that was the problem. One withdrew because of changes in their sense of taste, and another because of excessive weightloss.


When will follow-up trials start?

That's the million-dollar question. We don't know yet but we'll be keeping a very close eye out for any developments and will let people know of any news through our website and magazines.

If you'd like to read the full scientific paper it's available here:

http://www.jci.org/articles/view/68295


Hope that helps

Best wishes

Claire
Research team

#10
Thanks for the reply, research team.

#11

Hi Everybody, hope you are all not too bad today.

So great news about Exanatide, what do you all think?

Dave.


#12

Questions for the research team if I may?

1) Given Exenatide and other GLP1 agonists have been prescribed millions of times over the last 10 years or so and the incidence in PD in diabetics is well characterized   (although not quite understood), has anyone looked at the millions of people taking GLP-1's to see if there is a lower incidence of PD than those on insulin or other treatments?    I would think there is enough data to mine.

2) liraglutide (another GLP1) is also being studied across the board for neurodegenerative diseases.   It also seems to edge out Exenatide in diabetes.   Any data out there on its ability to cross the blood brain barrier relative to exenatide?    

Thanks in advance!

 


#13

Hi Double, 

I've sent this over to the team and asked them to get in touch on here! Someone will be along soon to answer your questions. 

 

Kat


#14

Thanks Kat!


#15

Hi Double,

Thanks for your questions.

I couldn’t find any research looking into the incidence of Parkinson’s in diabetics taking GLP-1s. However research has shown a reduction in incidence of Parkinson’s in diabetics taking a glitazone drug (another drug for diabetes).

Research has shown that both exenatide and liraglutide can cross the blood brain barrier. So more research is needed to explore why more exenatide wasn’t reaching the brain in the trail conducted at UCL. 

After the results from the study that came out last week, we are expecting more research to explore whether other GLP-agonists, like liraglutide, may be more effective at crossing the blood brain barrier. We'll be keeping a close eye on these developments and sharing any updates via our usual channels. 

All the best,

Annie

Parkinson's UK Research Team

 


#16

Can someone explain this research to me , am confused , I understood meds for diabetes type 2 to lower glucose levels. ?

If you have PD for  instance and not diabetes why would this drug help?  if lowers sugars surely best to cut it out of your diet.

Sugar puts stress on the body and is an inflammatory substance, research on role of inflammation in the brain having a negative impact on brain cell survival.

It is interesting that research appears to me to be funded by companies selling medication.  

Is there any research projects on omitting sugar from the diet to assist brain health, and if there is who is funding it? Tate & Lyle or a pharmaceutical company, if you get my drift.

 


#17

Thank Annie,   

I guess I'll keep looking for new research updates.

 

TeeHee,

my understanding is that one of the challenges with exenatide is that it is old and the patents are expiring.  So there isn't a big incentive for the drug companies to fund trials.   By the time it got approved, there would be a load of generics undercutting price and smaller returns 


#18

Hi Everyone,

well these Exenatide trial results seem to have caught the PD community on the hop, there is much confusion about what to do next. Phase 3 would be the obvious step but who's going to fund that when the Byetta patent expires this year? And will another trial include a placebo group. Some people, even top clinicians say that a placebo group just puts people off participating, and is pointless anyway because we all know what happens with PD, you just get worse, as proved already by phase 2.

Maybe it's time to think outside the box.

Regards,

Dave.


#19

Hopeful in a word!

Frances


#20

I would like to respond to the query re sugar. I long cut all refined sugar out of my diet. According to the neurology team, I`m doing well. Who knows?

Anyway, it`s too punishing for a lot of people !  Banning cake and biscuits may be a step too far. I have long wondered if there`s anything going on re diet in the research ?

Frances