Each year, through the Linked Clinical Trials (LCT) initiative, drugs are selected by the Linked Clinical Trials committee, based on drug safety; the drug’s ability to pass the blood-brain barrier; mode of action relevant to putative disease mechanisms in Parkinson’s (PD); ability to measure the drug’s effectiveness; and whether there has been demonstrated success in several preclinical Parkinson’s models (Brundin et al 2013). 

2016 Update:

This year, after stimulating debate, the committee prioritised 5 of the 26 compounds that were recommended: MSDC-0160, Trehalose (which was initially discussed in 2012), MMF and Nortriptyline. Also of interest were the next generation of Diabetes type 11 treatments.

Our next job is to indentify the pathways necessary to bring these treatments forward to trial as well as continuing to focus our energies on the drugs that have already been prioritised in previous LCT meetings: NAC, Nilotinib and UDCA, Alogliptin and BG-12:

UDCA Ursodeoxycholic acid - is already used to treat liver disease and to lower cholesterol, but we are interested in its proven action to improve mitochondrial function (or energy production) in each cell, which in Parkinson’s is disturbed. Working closely with Dr Oliver Bandmann in Sheffield, we are designing a trial which will help us to truly evaluate UDCA's potential benefits in PD. We hope to have more information available late this summer and we will be seeking funding for this trial.

Alogliptin - is an oral drug that is thought to work by increasing the levels of active incretin hormones, which enhance insulin and reduce glucagon secretions, thereby reducing blood glucose levels. It is currently used as a diabetes drug however the LCT committee is interested to explore its development in PD. We are currently working with Takeda who own the drug to move this drug into a clinical trial in PD. Note - this work links to the preclinical work we are funding by Konrad Talbot and Christian Holscher.

BG12 (Dimethyl Fumarate Tecfidera) - is currently used as a treatment for Multiple Sclerosis, however we believe that it also has relevance in Parkinson’s. Before we can move this drug forward into trials however, we will need to identify how much of the drug crosses the blood brain barrier and therefore reaches the right target area in the brain. We are exploring what studies need to be done and how best to deliver this work which it is hoped will shortly lead on to a clinical trial.