The impact of Exenatide on motor complications in Parkinson’s disease
Chang P-S., Athauda D., Foltynie T., Chang P-S.
Parkinson’s disease (PD) is a neurodegenerative disease caused by the progressive loss of dopaminergic cells in the substantia nigra resulting in characteristic symptoms of tremor, rigidity, bradykinesia and postural instability. Dopamine replacement with preparations of Levodopa remains the gold standard of treatment; however, continued use together with disease progression can lead to the development of motor complications including the development of uncontrollable jerky movements termed Levodopa-induced dyskinesia (LID), which can be difficult to manage. Exenatide, a glucagon-like peptide-1 (GLP-1) receptor agonist, has been shown to have neuroprotective properties in various animal toxin model of PD and conferred motor and cognitive benefits in a small open label trial of moderate severity PD patients. In view of this, a Phase II trial was conducted – the Exenatide-PD trial – a randomized double-blinded, placebo controlled, single center, 60-week trial of Exenatide once weekly for the treatment of moderate severity Parkinson’s disease in 60 patients. In addition to other clinical rating scales, all patients had dyskinesia assessments at 12-week intervals using the Unified Dyskinesia Rating Scale, the MDS-UPDRS Part 4 and the 3-day Hauser diary. Our aims are to compare the different tools used to measure dyskinesia in Parkinson’s disease, to examine whether Exenatide could impact on Levodopa-induced dyskinesia and to explore the relationship between the change in dyskinesia severity and the change in the number of dopamine transporters via DaTSCAN analysis after the 60-week Exenatide-PD trial. The poster was presented at 2017 Queen Square Symposium.