In the realm of neurodegenerative diseases, the past year has witnessed a seismic shift. The FDA’s green light for Eisai and Biogen’s groundbreaking Leqembi in the battle against Alzheimer’s disease sent waves of celebration rippling through patients and researchers alike. And as we eagerly await the regulatory verdict on Eli Lilly’s donanemab, expected by the year’s end, the optimism is contagious.
Traditionally, Alzheimer’s and Parkinson’s diseases have been seen as distinct entities, sharing little more than their ominous progression and their impact on the brain’s proteins. But experts are now unveiling an exciting prospect: the surging momentum in Alzheimer’s research might just be the shot in the arm that Parkinson’s research sorely needs.
It’s all about delving deeper into the intricate biological mechanisms of neurodegeneration, embracing the power of biomarker data, and uncovering potential common ground.
These strides forward could revolutionize the way we approach clinical trials and data analysis in the realm of Parkinson’s disease. And with this newfound optimism comes the promise of increased funding, offering a glimmer of hope for a condition that has long posed a formidable challenge.
“There’s a palpable sense of hope within the field, a belief that we’re on the cusp of a breakthrough in neurodegeneration as a whole, not just within the confines of Alzheimer’s disease,” remarked Joanne Taylor, the Senior Vice President of Research at Gain Therapeutics.
In the enigmatic realm of Parkinson’s disease, a relentless battle rages within the brain. Here, in the mysterious substantia nigra, dopamine-producing neurons vanish like fading stars in the night sky.
But that’s not the end of the story. Most individuals grappling with Parkinson’s also harbor a troublesome intruder – the alpha-synuclein protein. This mischievous interloper morphs into menacing clumps known as Lewy bodies, lurking inside the neurons.
These unwelcome guests are the architects behind many of the motor and cognitive woes that accompany the disease. Yet, despite these insights, one puzzle remains unsolved: how to quantitatively track the progression of this formidable foe over time.
According to Akihiko Koyama, a leading figure at The Eisai Center for Genetics Guided Dementia Discovery, there’s a fascinating shift occurring in the world of neurodegenerative research. It all began with Alzheimer’s, but the ripple effects are being felt far and wide.
Koyama explains, “One remarkable transformation is how we are now defining diseases on a biological level, rather than just by their symptoms.” This seismic shift means researchers are no longer confined to a single measurement.
Instead, they can explore a myriad of biomarkers, from the enigmatic amyloid beta protein to the elusive tau protein, and even venture into the captivating realm of neuroimaging through MRI scans in the case of Alzheimer’s.
In the intricate world of Parkinson’s disease, there’s a biomarker stealing the spotlight – the elusive alpha-synuclein protein. Gene Kinney, the visionary CEO of Prothena, believes this protein may hold the key to understanding the disease long before its debilitating symptoms rear their head. According to Kinney, it likely plays a pivotal role in the disease’s genesis.
In a remarkable partnership with Roche, Prothena is embarking on a quest to tame Parkinson’s with an experimental treatment called prasinezumab. This innovative therapy takes aim at alpha-synuclein, aiming to halt its menacing spread between neurons.
The excitement is palpable as Roche has successfully enrolled participants for a Phase IIb study, and we eagerly await the unveiling of top-line data in 2024.
But this shift towards a biology-based approach isn’t exclusive to Alzheimer’s and Parkinson’s. Biogen’s Qalsody (formerly tofersen) for SOD1-ALS blazed a trail with FDA accelerated approval in April.
Surprisingly, it hinged on data demonstrating a reduction in the biomarker neurofilament light chain (NfL), despite a Phase III clinical endpoint failure. Now, according to Joanne Taylor, the landscape for investigational Parkinson’s drugs is undergoing a profound transformation.
Taylor highlights the significance of biomarkers, emphasizing that these diseases stealthily brew long before symptoms emerge. Incorporating biomarker data into Parkinson’s clinical trials presents a tantalizing proposition.
Firstly, it allows for earlier enrollment, potentially intercepting the disease’s progression before motor and neurological symptoms wreak havoc. The prospect of prevention rather than decades-old reversal is a beacon of hope.
Secondly, collecting an array of biomarkers for trial participants increases the chances of spotting a significant signal that a drug is making headway, shedding light on its mechanism of action.
Lastly, biomarkers serve as early indicators, guiding the decision to continue or halt a lengthy and resource-intensive trial for a Parkinson’s drug candidate. This promising preliminary feedback isn’t just music to researchers’ ears – it’s a siren call for investors.
Taylor believes that showing an effect on biomarkers is a compelling reason to believe in a drug’s potential to tackle the disease, an enticement that’s bound to excite investors and drive progress in the field.
In the captivating world of neurodegenerative diseases like Alzheimer’s and Parkinson’s, two proteins, amyloid beta and alpha-synuclein, take center stage. What makes them truly intriguing is their shared trait – they’re both deemed pathological culprits.
These proteins aren’t mere spectators; they’re believed to be the driving forces behind the relentless progression of these debilitating conditions, rather than mere markers indicating the disease’s presence.
While amyloid beta and alpha-synuclein are distinct proteins with their own unique impact on neurons, Akihiko Koyama suggests that the quest to decipher the origins of Alzheimer’s might unveil a hidden connection.
Could it be that these misfolded proteins, though targeting different bullseyes, share a remarkably similar mechanism in their creation and dissemination? The mystery deepens, and the pursuit of answers continues.
But the intrigue doesn’t stop there; the reciprocal benefits of this neurodegenerative dance are equally tantalizing. Gain Therapeutics, with their arsenal of disease-modifying compounds for Parkinson’s, has sprung a surprise. Their small-molecule structurally targeted allosteric regulators (STARs) have shown promising early signs of influence in the Alzheimer’s arena too.
These compounds, by enhancing lysosomal health, might be tackling the root causes of both diseases. In cellular models of Alzheimer’s, Gain’s compounds swoop in to thwart amyloid beta toxicity and curb tau hyperphosphorylation.
Joanne Taylor envisions a groundbreaking possibility – the improvement of lysosomal health could hold the key to unlocking a Pandora’s box of potential treatments for various diseases entangled in the web of protein misfolding. It’s a thrilling prospect, one that might reshape the landscape of neurodegenerative research as we know it.
A Boon for Collaborations
In the intricate world of neurodegenerative research, success in Alzheimer’s clinical trials isn’t just a scientific triumph; it’s a testament to the collaborative spirit underpinning this noble quest, as Gene Kinney passionately emphasizes.
The Alzheimer’s Disease Neuroimaging Initiative (ADNI) stands as a colossal monument to collaboration, where the realms of academia, industry, and government research institutions converge.
These massive studies are like bridges that unite diverse minds, working tirelessly to unravel the mysteries of Alzheimer’s. But it doesn’t end there; a parallel effort in the form of the Parkinson’s Progression Markers Initiative (PPMI), led by the Michael J.
Fox Foundation, aspires to replicate this level of synergy. In 2021, they made waves by announcing their ambitious plans to triple enrollment in a longitudinal clinical study.
One of their noble objectives is to pinpoint biomarkers at every stage of Parkinson’s, a treasure trove of insights that’s bound to be a boon for drug developers, according to Kinney.
And here’s a vital lesson that transcends therapeutic boundaries: the pursuit of a Parkinson’s cure should be more akin to a symphony of effective drugs rather than a solitary magic bullet.
The groundbreaking approval of an Alzheimer’s therapy has breathed new life into Parkinson’s research, igniting the hope that a multi-pronged approach will yield the ultimate reward.
Kinney puts it succinctly, “In the realm of medicine, that first breakthrough is akin to a beacon of promise, a sign of better things on the horizon.” What we’re witnessing today, he suggests, is merely the tip of the iceberg, a mere glimpse into the vast potential that lies ahead in this awe-inspiring field of research.