A DRUG used to treat diabetes could slow the debilitating progression of Parkinson’s disease, scientists say.
Parkinson’s is a devastating nervous system disorder affecting 10 million people worldwide, with no current cure.
GettyGLP-1 drugs could be used to slow Parkinson’s after a type 2 diabetes drug showed promised in French study[/caption]
Symptoms include rhythmic shaking known as tremors, slowed movement, impaired speech and problems balancing, which get worse over time.
Researchers have been exploring a class of drugs called glucagon-like peptide-1 receptor agonists (GLP-1 RA) for their potential to protect brain neurons.
GLP-1 RAs are now commonly used to treat diabetes and obesity. A widely-known example of a GLP-1 drug is Ozempic, while Wegovy is for weight loss.
In a new study published in the New England Journal of Medicine, 156 patients with early-stage Parkinson’s were recruited across France.
Researchers chose to test the drug lixisenatide. Made by Sanofi and sold under the brand names Adlyxin and Lyxumia, the type 2 diabetes drug has since been discontinued in the UK.
Patients were randomly chosen to receive daily injections of lixisenatide or a placebo.
This is the first time that we have clear results, which demonstrate that we had an impact on the progression of the symptoms of the disease
Olivier Rascol
After one year of follow up, the group on taking the diabetes drug saw no worsening of their movement symptoms, while those on the placebo did.
The effect was “modest” according to the paper, and was noticeable only when assessed by professionals “who made them do tasks [such as ]walking, standing up, moving their hands”, senior author Olivier Rascol, a neurologist at Toulouse University, said.
But, he added, this may just be because Parkinson’s disease worsens slowly, and with another year of follow up, the differences might become much starker.
So far, evidence of the clinical benefits of GLP-1 drugs in patients with Parkinson’s has been limited and early studies have proved inconclusive.
“This is the first time that we have clear results, which demonstrate that we had an impact on the progression of the symptoms of the disease and that we explain it by a neuroprotective effect,” Dr Rascol said.
Gastrointestinal side effects were common on the drug and included nausea, vomiting and reflux, while a handful of patients experienced weight loss.
Dr Rasol and co-author Wassilios Meissner, a neurologist at Bordeaux University Hospital, both stressed more study would be required to confirm safety and efficacy before the treatment can be given to patients.
Promising findings that need replication
Michael Okun, medical director of the Parkinson’s Foundation, said that from a practical standpoint, the differences in patient outcomes were not clinically significant, but “statistically and compared to other studies, this type of difference should draw our interest and attention”.
“Experts will likely argue whether this study meets a minimum threshold for neuroprotection, and it likely does not,” Dr Okun said, adding the weight loss side effect was concerning for Parkinson’s patients.
Rodolfo Savica, a professor of neurology at the Mayo Clinic in Minnesota added: “The data so far are suggestive of a possible effect – but we need to replicate the study for sure.”
According to Parkinson’s UK, diabetes drugs like lixisenatide are being scrutinised by scientists for treating Parkinson’s because GLP-1 receptors are also found in the brain.
Lab-based experiments have suggested that activating them can boost the function of dopamine connections, have anti-inflammatory properties, improve energy production, and switch on cell survival signals.
Lixisenatide is the second diabetes drug to go through clinical trials for Parkinson’s, the first being exenatide.
Professor David Dexter, director of research at Parkinson’s UK, said of the new study: “The most significant part of these results are the lack of deterioration seen in the clinical measurement of motor symptoms in those receiving lixisenatide over the 12 months.
“This is promising, but from this study it’s hard to say whether the drug is slowing the progression of the condition. A longer trial could be able to show this and could be a logical next step.
“It will be interesting to see the results from a similar drug called exenatide.
“Previous clinical trial results suggest it could be more beneficial than lixisenatide.”
Research shows that GLP-1 drugs could be harnessed to improve health in other ways, as they appear to have potential to treat Alzheimer’s, as well as heart disease, fatty liver disease, and chronic kidney disease.
It’s been suggested that patients with sleep apnoea, heart failure and alcohol addiction could also benefit.
Everything you need to know about drugs like Ozempic
HERE’S what you should know about Ozempic, Wegovy, Saxenda and Mounjaro.
Weight loss jabs are a hot media topic at the moment, with hundreds of success stories sharing how they helped them shed the pounds.
In March 2023, the NHS announced it would make Wegovy, a drug made by Danish firm Novo Nordisk, available on prescription to thousands of obese Brits.
It contains the drug semaglutide, which is said to have helped reality star Kim Kardashian and Twitter boss Elon Musk lose weight.
Wegovy, which helped a third of people reduce their weight by 20 per cent in trials, is now available from pharmacies like Boots.
How do they work?
The jabs work by suppressing your appetite, making you eat less calories and therefore lose weight.
To do this, an ingredient found in the fat-busting drug, known as Semaglutide, mimics the role of a natural hormone, called GLP-1.
GLP-1 is part of the signalling pathway that tells your body you have eaten, and prepares it to use the energy that comes from your food.
London GP and founder of wellgoodwellbeing.com, Dr Zoe Watson, said: “Your body naturally produces an appetite regulating hormone called glucagon-like peptide-1.
“These jabs work by regulating your appetite, which can lead to eating fewer calories and losing weight.”
Aren’t they diabetes drugs?
Semaglutide, the active drug in Wegovy, was originally sold under the name Ozempic specifically for diabetes patients.
But they started noticing it helped suppress their appetites, stopping them eating as much and helping them shed the pounds.
So Novo Nordisk developed Wegovy, which contains the same chemical but at higher doses specifically to aid weight loss.
Wegovy is not prescribed for diabetes patients.
Can I get them?
Wegovy is offered on prescription to obese adults given specialist weight loss treatment.
The NHS currently also offers a similar drug called Saxenda, or liraglutide.
Both are only available on Tier 3 and Tier 4 weight management services, which means you have to be referred to weight management clinics led by experts.
GPs can’t prescribe them on their own either, Dr Watson said.
The jabs have to be taken as part of an overall programme to help with lifestyle changes and psychological support to get the best effect from the medication prescribed.
But despite being approved for use, supply of Wegovy on the NHS has been postponed indefinitely because of a surge in worldwide demand.
Supply was also halved in the US because of the skyrocketing demand.
Are there any risks?
Like all medicines, the jabs do not come without side effects.
Around half of people taking the drug experience gut issues, including sickness, bloating, acid reflux, constipation and diarrhoea.
Dr Sarah Jarvis, GP and clinical consultant at patient.info, said: “One of the more uncommon side effects is severe acute pancreatitis, which is extremely painful and happens to one in 500 people.”
Other uncommon side effects include altered taste, kidney problems, allergic reactions, thyroid tumours, gallbladder problems and hypoglycemia.
What other options are there?
Mounjaro (brand name for tirzepatide) also came onto the market in early 2024.
Like Wegovy, tirzepatide stems from a drug originally designed to treat diabetes.
The weekly injection helped overweight people drop more than two stone in 18 months.
It is available with to order with a prescription online from pharmacies including Superdrug and LloydsPharmacy Online Doctor.
It works in a similar way to Wegovy and Saxenda, but is more effective.
Dr Mitra Dutt from LloydsPharmacy says: “Based on clinical trials, 96 per cent of people were able to lose more than five per cent of their body fat using Mounjaro. In similar trials, 84 per cent of people lost more than five per cent of their body weight on Wegovy, and 60 per cent on Saxenda.
“Mounjaro works by activating two hormonal receptors (GIP and GLP-1), which enhance insulin production, improve insulin sensitivity, and work to decrease food intake.”
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