What’s going on with research into Parkinson’s?
We chat to Dr Kevin McFarthing who helps to summarise all of the active research into Parkinson’s in a way that everyone can understand. He tells us, of the 147 ongoing registered clinical studies, what treatments he thinks are the most promising and how best to stay up to date.
We frequently get asked, "so, what’s going on with research into Parkinson’s?" And the answer is a lot! This is promising and reassuring, but it can also be overwhelming for people to stay up to date with research in a way that’s understandable and manageable.
To help cover some of the ways you can stay up to date and to gather some insights into ongoing Parkinson’s research, we chatted with Dr Kevin McFarthing, who was diagnosed with Parkinson’s in 2012.
He is involved in mapping the research landscape, including all the registered clinical studies that are ongoing for Parkinson’s. Not an easy feat! He uses his expertise as a biochemist as well as his motivations of being someone who has Parkinson’s to rise to the challenge.
How are you involved in helping people to stay up to date with research?
I collate what I call the Parkinson’s Hope List (Excel, 104KB) and have been keeping this up to date since 2016. This is a database of all of the drug research and development projects across the globe that are currently underway for Parkinson’s, not only clinical studies but also those that are in the scientific discovery phase in the lab.
After I was diagnosed with Parkinson’s back in 2012, I spent time doing lots of Google searches trying to find out what research was going on. I needed a more organised way of capturing the ongoing research, and to see what might be close to the clinic. I also wanted to understand how this knowledge could help me, and others, to better manage the condition. So, I collected all of this to form the Hope List.
The list has roughly 370 research studies that are ongoing for Parkinson’s and also lists the 200 or so projects that have been stopped or have been completed.
The Hope List also helps as part of my work as the joint editor of the Clinical Trials Highlights section of the Journal of Parkinson’s Disease, working alongside my co-editor Professor Tanya Simuni from Northwestern University in the US.
Tell us more about these Clinical Trials Highlights articles
I help to publish regular articles that give short summaries and overviews of some of the key areas of clinical research. That means research that is already trialling potential treatments and therapies in people with and without Parkinson’s. The articles are for anyone that is interested in Parkinson’s research. Readers don’t need to have in-depth scientific knowledge to be able to take something away from these articles.
I started this in 2019. These articles range from summarising the research into therapies for thinking and memory problems in Parkinson’s, to focusing on a specific drug class, or sometimes giving an overview of the whole clinical trials landscape for the condition. We are also hoping to focus on more non-drug related areas soon, for example, research into exercise.
The articles are not too in depth. For instance, we published an article on infusion therapies and it summarises the science and what’s currently being investigated. We also include links to places to find out more, such as the list of active clinical studies registered on the clinicaltrials.gov website.
These articles are open access — meaning everyone can read them as they are not behind a paywall like some other research publications.
Can you explain the different stages a therapy has to go through before it is approved?
The process of taking an idea from the lab and turning it into an approved treatment in the clinic is long and costly. There are inevitably going to be avenues that are explored that reach a dead end but we are always gaining knowledge and getting closer to the end goal. There is a huge amount of research going on and global collaborations, such as the Parkinson’s Virtual Biotech, aim to speed up drug development for Parkinson’s.
You recently summarised the clinical trials landscape. What are the key takeaway points?
The most recent summary looked at clinical trials that were active as of January 2022.
There are 147 active clinical trials registered for Parkinson’s on clinicaltrials.gov. This is similar to the number of projects pre-covid, and this is very reassuring. It shows, despite the pandemic, investment and momentum seem to have been maintained. It also shows the wide range and quantity of research that is ongoing for Parkinson’s across the globe.
Breakdown of the number of clinical studies in the pipeline for Parkinson’s:
- 91 trials are focused on short-term symptomatic relief
- 56 trials aim to modify the course of Parkinson’s progression.
Of these trials:
- 51 are in phase 1 clinical trials (early safety)
- 74 are in phase 2 clinical trials (safety and early efficacy)
- 22 are in phase 3 clinical trials (large scale efficacy and safety).
Read more about the clinical trial pipeline on the IOS Press website. This includes a diagram that lists the specific names of the treatments and therapies being investigated.
Are there any particular areas of research or clinical trials on the Hope List that you are excited about?
March 2022 saw the publication of results from a phase 2 trial looking at whether a drug called ANAVEX 2-73 could improve cognitive symptoms in Parkinson’s. After 14 weeks of treatment, they found a significant improvement in thinking and memory assessments as well as other motor and non-motor symptoms. This is very promising considering this is a relatively short treatment period. We are awaiting news of a phase 3 trial to further investigate these benefits in a larger number of people.
Clumps of a protein called alpha-synuclein are thought to be contributing to brain cell death in Parkinson’s. It’s a busy area of research for Parkinson’s, although the theory has yet to be proven in the clinic.
There have been some recent results from trials looking at using antibodies, weapons from the immune system, to target and remove the protein, however, I don’t think this is the way forward. Read more about the results from trials of vaccines for Parkinson's.
However, those treatments that aim to make a helpful form of alpha-synuclein more readily available to the cell I think are particularly interesting. For instance, the drug being looked at by Enterin ENT-01. A recent phase 2 trial tested this for constipation in Parkinson’s, over a 13-week treatment period. It showed benefits not only for constipation but other symptoms of Parkinson’s and these benefits persisted for 6 weeks after treatment. The Parkinson's Virtual Biotech has also recently announced investment to take this drug forward to clinical trials for Parkinson's dementia. Read more about the Parkinson's dementia research project.
I think these are probably the closest to the patient in terms of being in later stages of research. This is helped by the fact that the drugs have already been shown to be safe for use in people with diabetes. The drugs work by targeting a receptor in the pancreas that binds GLP-1 and then triggers insulin release. Crucially these receptors are also present inside the brain. Research in the lab has suggested they play some role in protecting or supporting the brain cells which are affected in Parkinson’s. There have also been clinical studies that have shown benefit.
The one people are most familiar with is called exenatide and there is a phase 3 trial ongoing in the UK. Recruitment is now closed, meaning that the study looking at 200 participants over 2 years is well underway. Stay up to date on the Exenatide trial on UCL's website.
Are you involved in other activities to help influence and share Parkinson’s research?
I am on the research committee for Cure Parkinson’s where I play a role in helping to decide which research the charity funds. I am also a Research Champion for the Parkinson’s UK Oxford Branch, helping to spread the latest news and opportunities for people in my area.
Find out more about becoming a Research Champion.
Have you taken part in any research yourself? And, if so, why?
I have taken part in 17 observational studies. These are studies that are contributing to building a more complete picture of Parkinson’s, its symptoms and how it progresses.
They have been very interesting to be a part of. I have found out a lot about myself and the research itself. Some have also been good fun!
Also, a bonus is that I have definitely had more contact with Parkinson’s researchers and clinicians than I would have had otherwise.
What would you encourage people to do after reading this article?
- Read the Clinical Trial Highlights in the Journal of Parkinson’s Disease.
- Look at the Take Part Hub to find studies looking for people to take part today.
- Look to see if there is a local Research Interest Group near you. It is a great place to start if you want to get more involved with research.
- Join the Research Support Network to stay up to date with news and opportunities by email.
- I would also encourage people to read further articles on the Parkinson’s UK blog and Simon Stott’s blog "The Science of Parkinson’s". Both cover a range of topics and hold a tremendous amount of information.
Thanks to Kevin for chatting to us and helping to edit this blog.
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