Will we eventually be able to slow the progression of Parkinson's disease, the second most common neurodegenerative disorder – affecting over 167,000 people in France, with 25,000 new diagnoses a year – after Alzheimer's? This is the hope raised by a study conducted on patients by the NS-Park network of French Parkinson's disease expert centers, published on April 3 in the New England Journal of Medicine (NEJM).
This hope is based on a molecule uncommon in the neurological field: an anti-diabetic from the GLP-1 analog family, which includes the well-known Ozempic (semaglutide) drug, better known for its misuse in weight loss than for its primary application, type 2 diabetes. GLP-1 is a hormone that controls blood glucose levels and reduces appetite. Secreted by intestinal cells in response to food intake, it stimulates insulin production by pancreatic cells. Its analogs are therefore considered weapons of choice against type 2 diabetes, linked to a deficiency in insulin production or function.
According to the preliminary trial published in the NEJM, a drug from the GLP-1 analog family, lixisenatide, could also slow the progression of Parkinson's disease. It was evaluated on 156 patients aged between 40 and 76 (average age 60), all diagnosed within the last three years. All were already being treated with L-Dopa or its equivalents: available for 50 years, these anti-Parkinson drugs are designed to compensate for the lack of dopamine, the neurotransmitter that enables certain neurons in the brain to communicate.
Truly 'transformative treatment'
Parkinson's disease is linked to the progressive degeneration of dopamine-producing neurons in the substantia nigra, a deep brain structure involved in the coordination of voluntary movement. The result is the motor deficits observed in patients: stiffness, tremors, and slowness of movement. By correcting the dopamine deficiency, L-Dopa alleviates their motor symptoms. "But it doesn't tackle the cause of the disease, and can't stop symptoms worsening over time," explained Olivier Rascol, a neuropharmacologist at the Centre Hospitalier Universitaire de Toulouse. Together with Wassilios Meissner, a neurologist at the Centre Hospitalier Universitaire de Bordeaux, he coordinated the clinical trial, which was conducted in 21 of the 27 French expert centers. The diabetes drug was provided free of charge by the Sanofi laboratory, which markets it in certain countries.
The 156 patients in the trial were randomly divided into two groups: half received a placebo, and the other half was given lixisenatide. These treatments were administered by daily subcutaneous injections – without either patients or doctors knowing which group they belonged to.
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