A daily capsule can treat early Parkinson’s disease and relieve symptoms — without the side effects of standard drug treatments.
It involves a combination of two existing Parkinson’s drugs, pramipexole and rasagiline, given at low doses in a slow-release formulation.
The idea is that their complementary processes work together to increase dopamine levels in the brain – a key trigger of the disease.
The fact that low doses are used means that the drugs will not cause unpleasant side-effects when they are used alone in much higher doses. These can include muscle spasms or weakness, nausea, dizziness and trouble sleeping.
In a recent trial, patients who received a new low-dose combination drug known as P2B001 had similar improvements in symptoms as seen with a standard treatment, but with significantly fewer side effects.
A daily capsule can treat Parkinson’s disease early and relieve symptoms — without the side effects of standard drug treatments (file photo)
And if P2B001 is approved by regulatory authorities, it could mean patients receive drug therapy upon diagnosis, rather than observation until symptoms worsen.
Currently, many doctors wait until patients’ symptoms become more severe before starting drug therapy to avoid complications such as dyskinesia (such as tremors and tremors).
A 2009 study in the journal Archives of Neurology found that 50 percent of those taking pramipexole alone developed dyskinesia.
Parkinson’s disease is caused by the loss of nerve cells in the brain that produce dopamine, a chemical messenger that helps control body movements.
If these cells are damaged or die, dopamine levels decrease and movements become slow and abnormal, causing tremors and balance problems to worsen over time.
Drugs used to treat Parkinson’s, such as levodopa, work by increasing dopamine levels. Although these can keep symptoms at bay for years, they can have side effects.
P2B001 is a combination of low-dose pramipexole and rasagiline, which is released slowly to maintain consistently high levels of dopamine throughout the day.
The two were chosen for their complementary mechanisms: while pramipexole works by mimicking the effects of dopamine, rasagiline effectively blocks the enzymes responsible for breaking down dopamine.
In a study of newly-diagnosed Parkinson’s patients, 147 received P2B001 and 72 were treated with pramipexole alone.
After 12 weeks, both groups had similar improvements in symptoms, but the P2B001 group reported significantly fewer side-effects such as nausea, dizziness and heart rhythm problems – and most notably, less daytime sleepiness.
“The sum of the parts is much greater than the individual components,” said Lawrence Elmer, professor of neurology at the University of Toledo in the US, who presented the results of the trial at a recent meeting of the American Academy of Neurology.
‘One of the biggest questions for clinicians treating Parkinson’s patients is, “What and when do I start newly diagnosed patients?”,’ he said.
‘This inability of clinicians to know what to initiate in patients increases the cost of caring for these patients because they are inadequately managed.’
He added: ‘The goal was to design a compound that could be given to literally every newly diagnosed patient with Parkinson’s, that would work in most of those patients, with the best tolerability I’ve seen in a compound in nearly 20 years. .’
Claire Bell, of the charity Parkinson’s UK, told Good Health: ‘Recent trial results show that the two drugs given together provide better symptom control than either used alone and appear to have fewer side effects.’
He added that a major advantage of P2B001 is that it is taken once a day.
Currently, many clinicians wait until symptoms become more severe before initiating drug therapy to avoid complications such as dyskinesia (such as tremors and tremors) in patients.
‘Many people with Parkinson’s disease take multiple medications throughout the day,’ he explained, ‘so if this new drug could reduce that burden, it would be a significant step forward.’
The manufacturer, Pharma2B, plans to submit for approval to market the drug in the United States soon; Claire Bell predicts it could take one to two years for the drug to become available in the UK.
Another promising line of research is drug repurposing — that is, testing drugs originally designed to treat other conditions for their potential use in Parkinson’s.
Large ongoing clinical trials include testing cholinesterase inhibitors (used to treat Alzheimer’s memory problems) to see if they can improve walking and prevent falls in people with Parkinson’s disease.
There are also ongoing studies of the diabetes drug exenatide and the cough drug ambroxol as potential treatments to slow the progression of Parkinson’s.
Another option is to transplant new dopamine-producing cells, grown in a laboratory from human stem cells.
A ground-breaking animal study, led by Roger Barker, Professor of Clinical Neuroscience at Cambridge University, showed the method to be safe and effective in reversing motor deficits.
Professor Barker told Good Health: ‘In the future, people with Parkinson’s may receive stem cell-derived dopamine transplants.
‘Then you won’t need to take any drugs because the dopamine cells will do the job that the drugs are currently doing.
‘Stem cell-derived dopamine cells are designed to repair and replace lost dopamine cells. They will alleviate the disease and will be a virtual cure for many elderly patients.’
Dynamic Duos: Nutrients that work best when taken together
This week: Lycopene and ‘good’ fats
Tomatoes are one of the best sources of lycopene, a powerful antioxidant plant pigment that studies show may improve heart health and reduce the risk of some cancers.
‘Like many antioxidant plant pigments, lycopene is better absorbed by the body when consumed alongside healthy fat sources, such as olive oil, seeds, nuts or avocados,’ says dietitian Orly Rhodes.
In fact, research from Ohio State University in the US found that tomato salsa (sliced tomatoes with onions, herbs and spices) with avocado (a fat source) quadrupled lycopene intake, when compared to eating salsa with no added fat.
‘Cutting, pureeing and cooking tomatoes before you eat them is also important for lycopene access,’ says Orly Rhodes.
‘This helps break down the tomato cells and soften the fibre, which can almost triple the available lycopene.’
Try: If you’re not into salsa or guacamole, make a sauce with canned tomatoes (which are precooked) and a tablespoon of olive oil. Alternatively, you can have sardines in tomato sauce or roast tomatoes with olive oil and herbs.