Stiff muscles, uncontrolled trembling, slowed movements – these are classic symptoms of Parkinson’s disease. It is considered the second most common neurodegenerative disease after Alzheimer’s. According to the German Society for Parkinson’s and Movement Disorders (DPG), around 400,000 people in Germany are affected.
Parkinson’s disease is still considered incurable. But research is making great progress. New hope: the active ingredient lixisenatide, which is actually used to treat diabetes.
Diabetes drug could slow progression of Parkinson’s disease
“The substance lixisenatide slows the progression of symptoms to a small but statistically significant extent,” says the DPG in a press release on the new study. “The results are very interesting. If Parkinson’s could be slowed down with this class of medication, it would be a huge success,” says Joseph Claßen, first chairman of the DPG and director of the clinic and polyclinic for neurology at the University Hospital Leipzig.
The effectiveness of diabetes medications in Parkinson’s disease has been studied for some time. However, the current study is the first multicenter clinical trial to provide evidence of effectiveness.
So love the Study: The study examined 156 people with mild to moderate Parkinson’s symptoms, all of whom were already taking the standard Parkinson’s drug levodopa or other medicines. Half received the active ingredient lixisenatide for a year, the other a placebo.
Result: After twelve months, participants in the placebo control group showed a worsening of their symptoms, as expected. Her score had increased by three points on a Parkinson’s disease severity scale that measures how well those affected can carry out tasks such as speaking, eating and walking. For those who took the drug, the score on this scale did not change.
Side effects: Nausea occurred in nearly half and vomiting in 13 percent of people who took the drug. Newer drugs in the same class of substances may have fewer and milder side effects or may work at lower doses.
Evaluation: “The result is interesting because of the study design. However, you have to take into account that three points in the evaluation are few. Further studies must follow, among other things, to clarify how the effect develops over several years,” explains Claßen.
The principle of action of diabetes medications in Parkinson’s disease is unclear
According to the DPG experts, it is still unclear how the positive effect of the diabetes medication on Parkinson’s can be explained. But: “The active ingredient lixisenatide, which is approved for the treatment of type 2 diabetes, is a so-called GLP-1 receptor agonist. It mimics the action of the naturally occurring peptide and activates an intracellular signaling cascade, which plays an important role in maintaining physiological blood sugar levels.”
GLP-1 receptor agonists have recently made headlines. They are used, among other things, in the “weight loss injection” (active ingredient semaglutide). “GLP-1 drugs are known to reduce inflammation – this may have something to do with how they work,” say the experts.
If Parkinson’s disease could be slowed down with this class of medication, it would be “a huge success,” concludes Claßen. “However, long-term studies still need to be carried out, including with better-tolerated, related active ingredients, in order to demonstrate effectiveness and safety in more patients.”
Starts gradually: These are the typical Parkinson’s symptoms
Parkinson’s is also so tricky because it develops gradually. The first signs are often not yet associated with Parkinson’s. According to the DPG, these include REM sleep behavior disorders, smell disorders, vision disorders, pain in muscles and joints, reduced swinging of the arms when walking, fine motor skills disorders such as changed handwriting, tiredness, fatigue, insecurity and tremors.
The typical symptoms include later on
Shaking (tremor), stiffness of the muscles (rigor), slow movements (bradykinesia) and problems with balance.
Additional symptoms can include “freezing” of movements (freezing), difficulty speaking and swallowing, disorders of autonomic functions (e.g. blood pressure and digestion), sleep disorders, depression and mental impairments up to dementia.
Individual therapy: This is how Parkinson’s treatment works
Parkinson’s disease is primarily treated with medication. Because Parkinson’s symptoms can be alleviated by compensating for the dopamine deficiency, dopamine is administered as a medication (e.g. L-dopa) or the breakdown of the existing dopamine is prevented (MAO-B inhibitors, COMT inhibitors). Therapy is always carried out individually by a specialist.
Sometimes a brain surgical procedure, so-called deep brain stimulation (DBS), can also make sense. Physiotherapy, speech therapy, occupational therapy and, if necessary, psychotherapy can also help.