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The U.S. Food and Drug Administration (FDA) and Eli Lilly recently modified the WARNINGS and PRECAUTIONS sections of the drug Permax, a dopamine agonist used as adjunctive treatment to levodopa/carbidopa in the management of signs and symptoms of Parkinson's disease to warn doctors of the possibility of patients falling asleep while performing daily activities including driving a motor vehicle.
Scientists are investigating alternative methods for delivering levodopa, thus avoiding many of the side effects that come with the fluctuation of levels of orally administered levodopa in the blood. Among the techniques being studied are implantable pumps which provide a continuous controlled supply of levodopa. Other models being investigated include medicated skin patches and implanting capsules with dopamine producing cells in the brain. The drug would pass through the membrane of the capsule at a controlled rate.
Five new brain receptors for dopamine were recently identified. Researchers continue to look for ways to optimize drug delivery for Parkinson's disease using these receptors.
Investigators are studying the feasibility of genetically engineering cells (e.g., skin cells) that can be grown in the laboratory to produce dopamine and then implanting them into the brain of patients with Parkinson's disease. A great advantage would be that cells would be readily available and also that the cells would be obtained from the Parkinson's disease patient, thereby, eliminating the problem of immune rejection.
Research is being conducted regarding the use of the cholinesterase inhibitor rivastigmine for the treatment of cognitive impairment that is common to patients with Parkinson's disease.
Researchers at Columbia University are investigating the neuroprotective properties of a drug, DbHB (used to treat epilepsy) for Parkinson's disease since it has properties that restore brain function. DbHB has shown promising results in mice of protecting the brain against Parkinsonian degeneration.
On May 17, 2006, the U.S. Food and Drug Administration (FDA) approved a newer MAO-B drug called rasagiline (Azilect) for the treatment of Parkinson's disease. This drug was approved for use as an initial single drug therapy (monotherapy) for patients with early Parkinson's disease and in combination with levodopa in patients with more advanced Parkinson's disease.
Researchers are investigating the potential role of gene therapy for the treatment of tremors, shuffling gait, and dyskinesia in patients with Parkinson's disease. So far, gene therapy is in preliminary stages of investigation and has been tried on only a handful of people. Currently, this procedure is still considered experimental and is also controversial because it's effectiveness and potential long-term adverse effects are not yet known.
Researchers reported that five late stage Parkinson's disease patients showed significant improvement when the protein GDNF was introduced into the putamen area of the brain by a tube connected to a mini-pump. It reduced "off" time and reduced or eliminated dyskinesia. Some researchers see this exciting development as a potential vehicle to treat the underlying disease in addition to symptoms. This drug is still in very early stages of development and testing.
Studies have shown that caffeine may have protective properties against Parkinson's disease. Scientists are further studying this relationship between caffeine and Parkinson's disease in menopausal women on hormone replacement therapy.
Researchers from Israel recently reported that mutations in the glucocerebrosidase gene may predispose Jews of Ashkenazi decent to Parkinson's disease. Of the 99 Ashkenazi Jews with Parkinson's disease included in the study, 31 patients were found to have a mutation in the glucocerebrosidase gene. The study was published in the New England Journal of Medicine Vol. 351(19):1972-1977, November 4, 2004.
Trials of new medications intended to slow the progression of Parkinson's disease are currently underway. Information regarding ongoing clinical studies in your area can be obtained at the Clinical Trials Listing Service at http://www.centerwatch.com