特集 神経疾患治療の進歩2024
Parkinson病および関連疾患の治療の進歩
キーワード:
Parkinson disease,
motor symptom,
non–motor symptom,
symptomatic therapy,
disease modifying therapy
2025 年 42 巻 5 号 p. 818-822
詳細
2025 年 42 巻 5 号 p. 818-822
Here, we review papers published in 2024 on clinical trials, focusing primarily on pharmacotherapy for PD. Two phase 2 trials of GLP–1 receptor agonists for PD were reported ; lixisenatide suppressed progression of motor symptoms, whereas NLY01, a pegylated exendin–4 analogue, did not reach its primary endpoint. Of note, in subjects under 60 years of age, NLY01 also showed improvement in motor symptoms. A fourth year analysis of an open–label extension study of prasinezumab, a monoclonal antibody binding to aggregated α–synuclein, reported results suggesting inhibition of motor symptom progression in PD with the PPMI cohort as an external control. Another anti–aggregated α–synuclein antibody, Lu AF82422, demonstrated target engagement in human subjects. As an active immunotherapy, UB–312 was safe and induced immunity to α–synuclein. Fecal microbiota transplantation reported to be effective in 2023, but not in 2024. As a symptomatic therapy, levodopa–carbidopa (ND0612) continuous subcutaneous injection was reported to be effective in reducing off–time and has a good safety profile. P2B001, a fixed–dose combination of pramipexole extended–release and rasagiline, were useful as first–line treatment. The combination of buspirone and zolmitriptan, as well as the Chinese herbs Tianqi Pingchan granules and amantadine extended–release were useful in suppressing dyskinesia in PD. Clenbuterol may improve cognitive tasks in PD. Bumetanide and cannabinoids were ineffective against PD, while oxycodone and high–dose levodopa–benserazide were ineffective for central pain in PD. A pilot study demonstrated the usefulness of personalized adaptive deep brain stimulation. Two papers reported transcutaneous vagus nerve stimulation is effective for gait disturbance in PD. A report on language rehabilitation found that Lee Silverman voice treatment was effective and NHS speech and language therapy had no clinical efficacy. Acupuncture shown in a randomized controlled trial to be effective for sleep disturbances in PD. Palliative care contributes to improved QOL for patients with PD and related disorders.
