Seeking progress in disease modification in Parkinson disease

Parkinsonism Relat Disord. 2021 Sep:90:134-141. doi: 10.1016/j.parkreldis.2021.09.006. Epub 2021 Sep 10.

Abstract

Objective: Disease modification in Parkinson disease (PD) has remained an elusive goal, in spite of large investments over several decades. Following a large meeting of experts, this review article discusses the state of the science, possible reasons for past PD trials' failures to demonstrate disease-modifying benefit, and potential solutions.

Methods: The National Institute of Neurological Disorders and Stroke (NINDS) convened a meeting including leaders in the field and representatives of key stakeholder groups to discuss drug therapy with the goal of disease modification in PD.

Results: Important lessons can be learned from previous attempts, as well as from other fields. The selection process for therapeutic targets and agents differs among various organizations committed to therapeutic development. The areas identified as critical to target in future research include the development of relevant biomarkers, refinements of the targeted patient populations, considerations of novel trial designs, and improving collaborations between all stakeholders.

Conclusions: We identify potential barriers to progress in disease modification for Parkinson's and propose a set of research priorities that may improve the likelihood of success.

Keywords: Clinical trial; Disease modification; Parkinson; Pharmacotherapy.

Publication types

  • Research Support, N.I.H., Extramural
  • Review

MeSH terms

  • Biomarkers / analysis
  • Drug Discovery*
  • Humans
  • National Institute of Neurological Disorders and Stroke (U.S.)
  • Parkinson Disease / drug therapy*
  • United States

Substances

  • Biomarkers