Trial of Lixisenatide in Early Parkinson's Disease.
Humans
Antiparkinson Agents
/ administration & dosage
Disabled Persons
Double-Blind Method
Motor Disorders
/ drug therapy
Parkinson Disease
/ drug therapy
Peptides
/ administration & dosage
Treatment Outcome
Glucagon-Like Peptide-1 Receptor Agonists
/ administration & dosage
Disease Progression
Neuroprotective Agents
/ administration & dosage
Injections, Subcutaneous
Journal
The New England journal of medicine
ISSN: 1533-4406
Titre abrégé: N Engl J Med
Pays: United States
ID NLM: 0255562
Informations de publication
Date de publication:
04 Apr 2024
04 Apr 2024
Historique:
medline:
12
4
2024
pubmed:
10
4
2024
entrez:
10
4
2024
Statut:
ppublish
Résumé
Lixisenatide, a glucagon-like peptide-1 receptor agonist used for the treatment of diabetes, has shown neuroprotective properties in a mouse model of Parkinson's disease. In this phase 2, double-blind, randomized, placebo-controlled trial, we assessed the effect of lixisenatide on the progression of motor disability in persons with Parkinson's disease. Participants in whom Parkinson's disease was diagnosed less than 3 years earlier, who were receiving a stable dose of medications to treat symptoms, and who did not have motor complications were randomly assigned in a 1:1 ratio to daily subcutaneous lixisenatide or placebo for 12 months, followed by a 2-month washout period. The primary end point was the change from baseline in scores on the Movement Disorder Society-Unified Parkinson's Disease Rating Scale (MDS-UPDRS) part III (range, 0 to 132, with higher scores indicating greater motor disability), which was assessed in patients in the on-medication state at 12 months. Secondary end points included other MDS-UPDRS subscores at 6, 12, and 14 months and doses of levodopa equivalent. A total of 156 persons were enrolled, with 78 assigned to each group. MDS-UPDRS part III scores at baseline were approximately 15 in both groups. At 12 months, scores on the MDS-UPDRS part III had changed by -0.04 points (indicating improvement) in the lixisenatide group and 3.04 points (indicating worsening disability) in the placebo group (difference, 3.08; 95% confidence interval, 0.86 to 5.30; P = 0.007). At 14 months, after a 2-month washout period, the mean MDS-UPDRS motor scores in the off-medication state were 17.7 (95% CI, 15.7 to 19.7) with lixisenatide and 20.6 (95% CI, 18.5 to 22.8) with placebo. Other results relative to the secondary end points did not differ substantially between the groups. Nausea occurred in 46% of participants receiving lixisenatide, and vomiting occurred in 13%. In participants with early Parkinson's disease, lixisenatide therapy resulted in less progression of motor disability than placebo at 12 months in a phase 2 trial but was associated with gastrointestinal side effects. Longer and larger trials are needed to determine the effects and safety of lixisenatide in persons with Parkinson's disease. (Funded by the French Ministry of Health and others; LIXIPARK ClinicalTrials.gov number, NCT03439943.).
Sections du résumé
BACKGROUND
BACKGROUND
Lixisenatide, a glucagon-like peptide-1 receptor agonist used for the treatment of diabetes, has shown neuroprotective properties in a mouse model of Parkinson's disease.
METHODS
METHODS
In this phase 2, double-blind, randomized, placebo-controlled trial, we assessed the effect of lixisenatide on the progression of motor disability in persons with Parkinson's disease. Participants in whom Parkinson's disease was diagnosed less than 3 years earlier, who were receiving a stable dose of medications to treat symptoms, and who did not have motor complications were randomly assigned in a 1:1 ratio to daily subcutaneous lixisenatide or placebo for 12 months, followed by a 2-month washout period. The primary end point was the change from baseline in scores on the Movement Disorder Society-Unified Parkinson's Disease Rating Scale (MDS-UPDRS) part III (range, 0 to 132, with higher scores indicating greater motor disability), which was assessed in patients in the on-medication state at 12 months. Secondary end points included other MDS-UPDRS subscores at 6, 12, and 14 months and doses of levodopa equivalent.
RESULTS
RESULTS
A total of 156 persons were enrolled, with 78 assigned to each group. MDS-UPDRS part III scores at baseline were approximately 15 in both groups. At 12 months, scores on the MDS-UPDRS part III had changed by -0.04 points (indicating improvement) in the lixisenatide group and 3.04 points (indicating worsening disability) in the placebo group (difference, 3.08; 95% confidence interval, 0.86 to 5.30; P = 0.007). At 14 months, after a 2-month washout period, the mean MDS-UPDRS motor scores in the off-medication state were 17.7 (95% CI, 15.7 to 19.7) with lixisenatide and 20.6 (95% CI, 18.5 to 22.8) with placebo. Other results relative to the secondary end points did not differ substantially between the groups. Nausea occurred in 46% of participants receiving lixisenatide, and vomiting occurred in 13%.
CONCLUSIONS
CONCLUSIONS
In participants with early Parkinson's disease, lixisenatide therapy resulted in less progression of motor disability than placebo at 12 months in a phase 2 trial but was associated with gastrointestinal side effects. Longer and larger trials are needed to determine the effects and safety of lixisenatide in persons with Parkinson's disease. (Funded by the French Ministry of Health and others; LIXIPARK ClinicalTrials.gov number, NCT03439943.).
Identifiants
pubmed: 38598572
doi: 10.1056/NEJMoa2312323
doi:
Substances chimiques
Antiparkinson Agents
0
lixisenatide
74O62BB01U
Peptides
0
Glucagon-Like Peptide-1 Receptor Agonists
0
Neuroprotective Agents
0
Banques de données
ClinicalTrials.gov
['NCT03439943']
Types de publication
Randomized Controlled Trial
Clinical Trial, Phase II
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
1176-1185Investigateurs
Mathieu Anheim
(M)
Solène Ansquer
(S)
Antoine Benard
(A)
Isabelle Benatru
(I)
Thomas Boraud
(T)
N Boudjema
(N)
Christine Brefel-Courbon
(C)
Nicolas Carrière
(N)
Y Cazal
(Y)
Anne Chatelain
(A)
Olivier Colin
(O)
Anne-Gaëlle Corbillé
(AG)
Jean-Christophe Corvol
(JC)
Philippe Damier
(P)
Luc Defebvre
(L)
Estelle Dellapina
(E)
Pascal Derkinderen
(P)
David Devos
(D)
Sophie Drapier
(S)
Margherita Fabbri
(M)
Vanessa Ferrier
(V)
Alexandra Foubert-Samier
(A)
Solène Frismand
(S)
Aurore Georget
(A)
Christine Germain
(C)
Caroline Giordana
(C)
Stéphane Grimaldi
(S)
Clémence Hardy
(C)
Lucie Hopes
(L)
Jean-Luc Houéto
(JL)
Pierre Krystkowiak
(P)
Ouahaid Lagha Boukbiza
(OL)
Brice Laurens
(B)
Sévérine Le Dily
(S)
Romain Lefaucheur
(R)
Nadine Longato
(N)
David Maltête
(D)
Louise-Laure Mariani
(LL)
Ana Marques
(A)
Claire Marse
(C)
Wassilios G Meissner
(WG)
Caroline Moreau
(C)
Fabienne Ory-Magne
(F)
Clélie Phillipps
(C)
Emilie Rabois
(E)
Olivier Rascol
(O)
Philippe Remy
(P)
Vincent Rigalleau
(V)
Tiphaine Rouaud
(T)
Hayet Salhi
(H)
Amandine Saubion
(A)
Umberto Spampinato
(U)
Claire Thalamas
(C)
Claire Thiriez
(C)
Mélissa Tir
(M)
Christine Tranchant
(C)
Informations de copyright
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