Progress towards therapies for disease modification in Parkinson's disease.

The development of interventions to slow or halt the progression of Parkinson's disease remains a priority for patients and researchers alike. To date, no agents have been shown to have unequivocal evidence of disease-modifying effects in Parkinson's disease. The absence of disease-modifying treatments might relate not only to inadequate approaches for the selection of therapeutic candidates but also to insufficient attention to detail in clinical trial design. Better understanding of Parkinson's disease pathogenesis associated with advances in laboratory models, the use of objective biomarkers of disease progression and target engagement, and a focus on agents known to be safe for human use, alongside the use of precision medicine approaches, should together greatly increase the likelihood for successful identification of disease-modifying treatments for Parkinson's disease.

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Declaration of interests NV has received educational support from AbbVie, Stada, Ipsen, and Merck; speaker's honorarium from AbbVie and Stada; and served on advisory boards for AbbVie and Britannia Pharmaceuticals. TS has served as a consultant for Acadia, AbbVie, Accorda, Adamas, Allergan, Amneal, Aptinyx, Denali, General Electric, Kyowa, Neuroderm, Neurocrine, Sanofi, Sinopia, Sunovion, Roche, Takeda, Voyager, US World Meds, Parkinson's Foundation, and the Michael J Fox Foundation for Parkinson's Research (MJFF); TS has served as a speaker and received an honorarium from Acadia and Adamas; is on the scientific advisory board for Neuroderm and Sanofi; and has received research funding from the National Institute of Neurological Disorders and Stroke, Parkinson's Foundation, MJFF, Biogen, Roche, Neuroderm, Sanofi, Sun Pharma, AbbVie, IMPAX, and Prevail. HRM is employed by University College London. In the last 24 months he reports paid consultancy from Biogen, UCB, AbbVie, Denali, Biohaven, and Lundbeck; lecture fees or honoraria from Biogen, UCB, C4X Discovery, GE Healthcare, Wellcome Trust, and Movement Disorders Society; and research grants from Parkinson's UK, Cure Parkinson's, PSP Association, CBD Solutions, Drake Foundation, and the Medical Research Council. HRM is a co-applicant on a patent application related to C9ORF72—Method for diagnosing a neurodegenerative disease (PCT/GB2012/052140). OB has received grant support from the JP Moulton Charitable Trust, Cure Parkinson's, MJFF, and the Medical Research Council, and additional financial support from New Zealand Pharmaceuticals UK. TF has received grant support from Cure Parkinson's, MJFF, John Black Charitable Foundation, Van Andel Institute, Defeat MSA, Innovate UK, Rosetrees Trust, National Institute for Health Research, and the Edmond J Safra Foundation. He has received honoraria for speaking at meetings sponsored by Bial, Profile Pharma, Britannia, and Boston Scientific. He has served on advisory boards for Living Cell Technologies, Handl, Voyager Therapeutics, and Oxford Biomedica.