The Neurology Arena In Brief - A Round-up of Trends, Statistics and Clinical Research
The Neurology Arena In Brief - A Round-up of Trends, Statistics and Clinical Research
Parkinson's Disease
The major focus in Parkinson's disease (PD) during 2006 and continuing into 2007 has been non-motor symptoms (NMS). Traditionally held to be a movement disorder, there is increasing evidence that Parkinson's is, in fact, a spectrum of disorders that includes depression and other emotional and cognitive responses that affect overall quality of life.
These insights are underwritten by the Global Parkinson's Disease Survey (GPDS) undertaken by the European Parkinson's Disease Association (EPDA) and published in 1999.
The GPDS questioned more than 1,900 physicians, PD patients and care-givers about how the disease affected them. It found that around half of PD sufferers were depressed, but that only 1% of them had reported their depression as a problem. Many physicians think of depression as a consequence of the motility issues.
In November 2006, the UK Medicines and Healthcare products Regulatory Agency (MHRA) published a Public Assessment Report on the relationship between a popular type of PD treatment – dopamine agonists – and pathological gambling, increased libido and hypersexuality; conditions that can be just as destructive to a patient's life as the tremors. The report states that these conditions may be class effects of dopamine agonists, which are also used to treat restless legs syndrome and some endocrine disorders. New wording has been recommended for all dopamine agonists.
Multiple Sclerosis
At the annual meeting of the American Academy of Neurology (AAN) in May 2007, the winner of the John Dystel Prize for MS Research, Dr Howard Weiner, spoke of the possibility of finding a cure for multiple sclerosis (MS). He predicted that there would be a multifaceted cure that would address the diverse, chronic nature of MS, specifically:
- administering immunotherapy early, to halt disease progression;
- employing stem cells to reverse neurological damage; and
- finding MS biomarkers, with an end goal of developing methods of prevention.
Trial data for new therapeutics were also presented at the AAN meeting. Positive results were reported for various compounds, including:
- oral laquinimod (Teva Pharmaceutical Industries and Active Biotech);
- pioglitazone (Actos®, Takeda Pharmaceutical);
- oral Fampridine-SR (sustained-release formula of 4-aminopyridine, Acorda Therapeutics);
- fingolimod (FTY720, Novartis Pharma);
- rituximab (Rituxan®, Genentech and Biogen Idec); and
- alemtuzumab (Campath®, Genzyme – licensed from BTG).
Regarding alemtuzumab, the results came from the end of the second year of a three-year phase II trial comparing alemtuzumab with interferon beta- 1a (Rebif®, Merck-Serono) for the treatment of 334 patients with MS. Patients taking both high and low doses of alemtuzumab experienced at least a 75% reduction in the risk of relapse and at least a 65% reduction in the risk of progression of clinically significant disability compared with patients treated with interferon beta-1a.
