Clinical approaches to the development of a neuroprotective therapy for PD
- PMID: 28622912
- DOI: 10.1016/j.expneurol.2017.06.018
Clinical approaches to the development of a neuroprotective therapy for PD
Abstract
The development of a neuroprotective or disease-modifying therapy is the major unmet need in the management of Parkinson's Disease (PD) and the goal of much clinical and scientific research. However, despite enormous efforts and expense, no disease-modifying therapy for PD has been approved to date. Historically attempts to define such a therapy have been limited by confounding symptomatic/pharmacologic effects of the study intervention and the lack of a clear and well-defined regulatory and clinical development pathway that leads to a disease-modifying indication. Further, the costs of the development program average 1 billion dollars with a duration of 10 to 13years. As a consequence, many pharmaceutical companies are reluctant to test novel therapies despite the recent scientific advances and promising candidate targets and approaches. In the present review we describe previous studies aimed at defining a disease-modifying drug and discuss their limitations. We also consider some of the modern approaches and trial design for drug development that will hopefully pave the way toward identifying and gaining regulatory approval for a disease-modifying therapy in a relatively efficient and cost-effective manner.
Keywords: Neuroprotection; Parkinson disease.
Copyright © 2017. Published by Elsevier Inc.
Similar articles
-
Obstacles to the development of a neuroprotective therapy for Parkinson's disease.Mov Disord. 2013 Jan;28(1):3-7. doi: 10.1002/mds.25337. Mov Disord. 2013. PMID: 23390094 Review.
-
Neuroprotection in Parkinson's disease: clinical trials.Ann Neurol. 2003;53 Suppl 3:S87-97; discussion S97-9. doi: 10.1002/ana.10488. Ann Neurol. 2003. PMID: 12666101 Review.
-
Clinical neuroprotection in Parkinson's disease - still waiting for the breakthrough.J Neurol Sci. 2010 Feb 15;289(1-2):104-14. doi: 10.1016/j.jns.2009.08.025. Epub 2009 Sep 20. J Neurol Sci. 2010. PMID: 19772974 Review.
-
Why have we failed to achieve neuroprotection in Parkinson's disease?Ann Neurol. 2008 Dec;64 Suppl 2:S101-10. doi: 10.1002/ana.21461. Ann Neurol. 2008. PMID: 19127580 Review.
-
Advances in drug development for Parkinson's disease: present status.Pharmacology. 2014;93(5-6):260-71. doi: 10.1159/000362419. Epub 2014 Aug 1. Pharmacology. 2014. PMID: 25096413 Review.
Cited by
-
Systemic Exosomal Delivery of shRNA Minicircles Prevents Parkinsonian Pathology.Mol Ther. 2019 Dec 4;27(12):2111-2122. doi: 10.1016/j.ymthe.2019.08.010. Epub 2019 Aug 27. Mol Ther. 2019. PMID: 31501034 Free PMC article.
-
Rasagiline and selegiline modulate mitochondrial homeostasis, intervene apoptosis system and mitigate α-synuclein cytotoxicity in disease-modifying therapy for Parkinson's disease.J Neural Transm (Vienna). 2020 Feb;127(2):131-147. doi: 10.1007/s00702-020-02150-w. Epub 2020 Jan 28. J Neural Transm (Vienna). 2020. PMID: 31993732 Review.
-
Neurotrophic factors for disease-modifying treatments of Parkinson's disease: gaps between basic science and clinical studies.Pharmacol Rep. 2020 Oct;72(5):1195-1217. doi: 10.1007/s43440-020-00120-3. Epub 2020 Jul 22. Pharmacol Rep. 2020. PMID: 32700249 Free PMC article. Review.
-
Approaches to Disease Modification for Parkinson's Disease: Clinical Trials and Lessons Learned.Neurotherapeutics. 2020 Oct;17(4):1393-1405. doi: 10.1007/s13311-020-00964-w. Epub 2020 Nov 17. Neurotherapeutics. 2020. PMID: 33205384 Free PMC article. Review.
-
Autonomic dysfunction in Parkinson disease and animal models.Clin Auton Res. 2019 Aug;29(4):397-414. doi: 10.1007/s10286-018-00584-7. Epub 2019 Jan 2. Clin Auton Res. 2019. PMID: 30604165 Free PMC article. Review.
Publication types
MeSH terms
Substances
LinkOut - more resources
Full Text Sources
Other Literature Sources
Medical
Research Materials