Precision medicine in Parkinson's disease: emerging treatments for genetic Parkinson's disease

J Neurol. 2020 Mar;267(3):860-869. doi: 10.1007/s00415-020-09705-7. Epub 2020 Jan 23.

Abstract

In recent years, numerous clinical trials for disease modification in Parkinson's disease (PD) have failed, possibly because of a "one-size-fits all" approach. Alternatively, a precision medicine approach, which customises treatments based on patients' individual genotype, may help reach disease modification. Here, we review clinical trials that target genetic forms of PD, i.e., GBA-associated and LRRK2-associated PD. In summary, six ongoing studies which explicitely recruit GBA-PD patients, and two studies which recruit LRRK2-PD patients, were identified. Available data on mechanisms of action, study design, and challenges of therapeutic trials are discussed.

Keywords: Ambroxol; Clinical trial; GBA; Genetic Parkinson’s disease; Kinase inhibitor; LRRK2; SNCA; Small molecule compounds; Superprecision medicine; TORC1 inhibitor; Venglustat.

Publication types

  • Review

MeSH terms

  • Clinical Trials as Topic
  • Genetic Predisposition to Disease
  • Glucosylceramidase / genetics
  • Humans
  • Leucine-Rich Repeat Serine-Threonine Protein Kinase-2 / genetics
  • Molecular Targeted Therapy / methods*
  • Mutation
  • Parkinson Disease / genetics*
  • Parkinson Disease / therapy*
  • Precision Medicine / methods*

Substances

  • LRRK2 protein, human
  • Leucine-Rich Repeat Serine-Threonine Protein Kinase-2
  • GBA protein, human
  • Glucosylceramidase