These findings help the rationale behind a Part 3 trial known as Exenatide-PD3 (NCT04232969), which is exploring the therapeutic potential of exenatide (model names Byetta and Bydureon) — a GLP-1 agonist typically prescribed to deal with sort 2 diabetes — in sufferers with Parkinson’s. The trial, which is able to embody an estimated 200 sufferers, is being led by a workforce of investigators on the University College of London.
The research, “Diabetes medications and risk of Parkinson’s disease: a cohort study of patients with diabetes,” was printed within the journal Brain.
A number of research have reported that sufferers with sort 2 diabetes have a better danger of growing Parkinson’s in some unspecified time in the future of their lives.
Preclinical research have additionally advised that GLP-1 agonists may need neuroprotective properties that could possibly be helpful in treating Parkinson’s. These agonists are anti-diabetic medicines that assist decrease blood sugar ranges by mimicking the exercise of incretin hormones which can be naturally produced by the physique.
Following these findings, a number of medical trials have been launched to discover the potential of repurposing these medicines to deal with Parkinson’s. Data from a Part 2 trial (NCT01971242) evaluating exenatide in 60 people with Parkinson’s indicated that, when added to common antiparkinsonian medicine, exenatide may need optimistic results on sufferers’ motor operate.
With help from The Cure Parkinson’s Trust and the Barcapel Foundation, the present research was geared toward assessing and evaluate the Parkinson’s danger in a big inhabitants of sufferers with sort 2 diabetes who have been being handled with various kinds of anti-diabetic medicines, together with GLP-1 agonists.
Sufferers have been recognized and chosen utilizing The Health Improvement Network, a big database that comprises anonymized digital medical data collected from main care clinics throughout the U.Okay. All sufferers who have been identified with diabetes and obtained at the very least two prescriptions for anti-diabetic medicines between 2006 and 2019 have been included within the analyses.
Statistical analyses have been used to check Parkinson’s danger between sufferers being handled with glitazones, DPP4 inhibitors, and GLP-1 agonists and people receiving different oral anti-diabetic medicines. Sufferers utilizing insulin have been analyzed individually.
Of the 100,288 sufferers with sort 2 diabetes recognized, 329 (0.3%) have been identified with Parkinson’s in some unspecified time in the future throughout follow-up, which lasted a median of three.33 years.
Researchers in contrast 21,175 sufferers who have been being handled with glitazones, of whom 36,897 have been receiving DPP4 inhibitors, and 10,684 have been being handled with GLP-1 agonists. A sub-set of 38,393 sufferers have been being handled with different oral blood sugar-lowering brokers.
In contrast with sufferers receiving different anti-diabetic medicines (10 per 10,000 person-years), the incidence of Parkinson’s was decrease in these receiving glitazones (eight per 10,000 person-years), DPP4 inhibitors (5 per 10,000 person-years), and GLP-1 agonists (4 per 10,000 person-years).
For reference, person-years is a measure that takes into consideration the variety of individuals collaborating in a research and the period of time they have been adopted. So, 10,000 person-years pertains to information gathered by following 10,000 individuals for one yr.
No proof was discovered suggesting that the usage of glitazones could possibly be linked to a decrease danger of Parkinson’s. Nonetheless, the usage of DPP4 inhibitors and GLP-1 agonists was linked to a 36–60% decrease danger of Parkinson’s.
A separate evaluation carried out in sufferers utilizing insulin together with these medicines yielded related outcomes, regardless of being underpowered because of the small variety of contributors included.
“The usage of DPP4 inhibitors and/or GLP-1 receptor agonists is related to a decrease price of Parkinson’s illness in comparison with the usage of different oral antidiabetic medicine. Our research offers distinctive proof to help additional investigation of DPP4 inhibitor and GLP-1 receptor agonist use in Parkinson’s illness,” the researchers wrote.