Abstract Body

Research for the treatment of Parkinson’s disease is moving in two directions: one to delay or alt disease progression and another to provide better symptomatic treatment. Alpha-synuclein (α-Syn) is a major component of pathology that characterizes several neurodegenerative disorders including PD, dementia with Lewy bodies, and MSA. In synucleinopathies, the synuclein protein can misfold and aggregate to form soluble aggregates and insoluble fibrils that contribute to neuronal death. This disease-causing synuclein can be propagated and transmitted from neuron to neuron, resulting in an infection-like spread of neuronal death. Two studies with passive immunotherapies has been concluded. The PASADENA study tested prasinezumab and despite the primary end-point was not met positive signals were seen. A phase IIB study with this drug just started. The PARK study with BIIB054 did not met primary and secondary en-points. The ORCHESTRA study with UCB0059, an oral Asyn antibody is also recruiting. Attention is now paid to genetic forms of parkinsonism. Two molecules are in clinical trials for GBA mutation, ambroxol and venglustat and one for patients with LRKK2 mutation, DNL151. But research is also active for symptomatic treatment. Two rescue therapy were just approved an inhaling formulation of levodopa and a sublingual apomorphine. Moreover to achive a more contnuos delivery of drug two subcutaneous preparation of levodopa are in clinical trials and olso an otal micropump able to deliver levodopa continuously. A new dopamine agonist, tavapadon and two drugs for dyskinesia are in clinical trial too.