Neurology
Parkinson’s Disease
by Judy George, Deputy Managing Editor, MedPage Today
December 19, 2023
An investigational brain-penetrant, pegylated analogue of the glucagon-like peptide-1 (GLP-1) receptor agonist exenatide (Byetta, Bydureon) known as NLY01 did not lead to improvement in Parkinson’s disease symptoms compared with placebo, a phase II trial showed.
Neither 2.5 mg or 5.0 mg of weekly NLY01 injections showed any difference from placebo in the sum of Movement Disorder Society Unified Parkinson’s Disease Rating Scale (MDS-UPDRS) parts II and III scores at 36 weeks, according to Andrew McGarry, MD, of Rowan University in Camden, New Jersey, and colleagues.
However, a subgroup analysis suggested the possibility of motor benefit in participants under age 60, the researchers said.
“In a database of more than 100,000 individuals with diabetes, those using GLP-1 receptor agonists had a 62% lower risk of developing Parkinson’s disease,” McGarry and colleagues pointed out. In 2017, a single-center trial showed that exenatide had positive effects on Parkinson’s motor scores that continued beyond the period of exposure.
People with type 2 diabetes have an increased risk of Parkinson’s disease, particularly those with early diabetes onset (ages 25-44) and a low BMI (below 18.5), noted Claudia Trenkwalder, MD, and Brit Mollenhauer, MD, of the University Medical Center Göttingen in Germany, in an accompanying editorial.
Trials like the NLY01 phase II study that investigate the preventive potential of existing drugs are urgently needed, the editorialists observed.
McGarry and co-authors randomized 255 people with early untreated Parkinson’s disease to subcutaneous 2.5 mg or 5.0 mg NLY01,
