Parkinson’s hope

A diabetes drug for Parkinson’s

The Parkinson’s disease community got encouraging news last week when a team of French researchers reported that patients’ motor ability improved after a year’s treatment with an old diabetes medicine called lixisenatide. But when I called them, the research team had a message for patients: don’t take these drugs quite yet — at least not unless you also have diabetes or obesity.

The message is nuanced. It suggests Parkinson’s patients with other conditions that make them eligible for drugs like lixisenatide could consider taking them. The medicine is no longer sold in the US but there are newer options in the same class, including Novo Nordisk’s blockbusters Ozempic and Wegovy.

Last week’s study followed only 156 patients, not enough people to say for sure how big the benefit — and potential risks — of the drug could be. It didn’t follow them for long enough to see whether the impact increases over time. Also unclear is what dose might be most helpful.

“We wouldn’t like that they take our results too simplistically,” said Olivier Rascol, one of the study’s leaders, a Toulouse University Hospital neurologist and chairman of the French Clinical Research Network for Parkinson's Disease and Movement Disorders. “This is a proof of concept study and we need more data, more trials, before we can conclude and eventually recommend to treat patients with this strategy.”

There are crucial differences between Ozempic and the older lixisenatide. For one, Ozempic doesn’t penetrate the brain, according to Wassilios Meissner, who heads the neurodegenerative-disease unit at University Hospital Bordeaux and helped lead the study.

The researchers used the lixisenatide dose recommended for type 2 diabetes, yet when some patients went to a lower amount during the study because of nausea, a common side effect of the drug, there was no evidence it was working less well for their Parkinson’s disease, Rascol said. “A lower dose might be sufficient to protect the neurons,” he said.

Funded by Cure Parkinson’s and the French government, the study was a decade in the making. Now the researchers must convince local drugmaker Sanofi to make more of the drug for a large clinical trial. The company is open to a discussion about providing support for the next phase of research, a spokesman said in an e-mail. Meanwhile, results from a bigger trial of another old diabetes drug, AstraZeneca’s exenatide, are due out later this year — results which, if positive, could push more investment in the area, the French team said.

“It is not yet 100% sure,” said Rascol of the work with Sanofi. “But we are hoping that they will help us.” —Naomi Kresge

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