Living where we do, at the bottom of the world, can sometimes make it challenging to stay abreast of global developments, initiatives, and priorities in Parkinson’s research. Yes, research is published online, updates are frequently shared via social media, and Teams or Zoom calls are useful for semi-regular catch ups with our partner non-profit organisations in the UK, US and Australia. But there is no substitute for face-to-face catch ups and the intensity of a congress for really getting up to speed with the incredible volume of work and progress happening worldwide, and hearing updates prior to publication. Thus, it was a privilege for CEO Daniel to be invited to attend the international linked clinical trials (iLCT) meeting again this year, which was well planned to occur during the days immediately prior to the annual congress of the International Parkinson and Movement Disorders Society.
The iLCT programme was established in 2012 by our partner organisation Cure Parkinson’s (UK) to speed up the search for much-needed disease-modifying treatments (that can stop or slow progression) for Parkinson’s disease. It is a global programme centred around an annual two-day meeting at which a committee of >20 world-leading Parkinson’s experts evaluates, ranks, and prioritises a variety of drugs and compounds (normally 15–20 candidates, for which detailed dossiers are produced) with the potential to modify the progression of Parkinson’s. Drugs that are ranked highly enough are prioritised to move into clinical trials. There are several examples of iLCT committee-prioritized drugs that are now well into phase 2 or 3 clinical trials in people with Parkinson’s, such as the diabetes drug exenatide (one of a number of GLP-1 receptor agonists being assessed) and the cough suppressant ambroxol. The meeting this year was hosted by the impressive-looking Van Andel Institute in Grand Rapids, Michigan, and once again, there were some promising candidates reviewed and discussed, several of which will be prioritized for further investigation.
The meeting is also a great opportunity to learn about progress on existing trials and some of the initiatives aimed up speeding up the delivery of outcomes. The phase 3 trial of ambroxol is expected to commence very soon under the leadership of Tony Schapira in London, while the phase 3 exenatide trial led by Tom Foltynie (also based in London) has recently been completed, with results expected to be released later this month. Another trial of considerable interest is the NO-PARK study in Norway of the nutraceutical nicotinamide riboside (NR) being led by Charalampous ‘Haris’ Tzoulis, with the results of this trial expected in May 2025. If positive, it would be great to initiate a similar study in NZ. Haris is a rising star in the field of Parkinson’s research, and what he has been able to achieve in a country that is very similar in size to NZ is quite incredible.
It was fabulous to see representatives of Alzheimer’s Research UK present this year as well as the various Parkinson’s research-funding charities, with the learnings and sharing of knowledge being bi-directional. Charities in our space certainly know how to collaborate and share information for better efficiency and faster progress—always great to see! ARUK is one organisation that has grown impressively fast, leading to a significant investment (>£220M since 1998) in Alzheimer’s and dementia research, and some impressive outcomes.
With a shared goal of speeding up research and clinical trials to bring potential disease-modifying therapies to patients sooner, researchers in a number of countries are developing so-called multi-arm, multi-stage (MAMS) platform trials for the simultaneous testing of different interventions and more rapid progression from phase 2 into phase 3 clinical trials. The analogy that is often used is that of a football stadium: the way trials are traditionally conducted in most places is analogous to building a stadium for one match, then disassembling the stadium following the game, and doing this for every match! Ludicrous of course, but it is how the process has evolved (largely with patient safety in mind, but with obvious implications for costs and speed to generate outcomes). MAMS platform trials, which build the stadium once for multiple matches (ongoing clinical trials), are now established the UK (EJS-ACT-MAMS) and US (P2P), with similar platform trials being established in France and Norway. Australia also has a multi-arm trial platform (although it is not multi-stage, so is technically not a MAMS trial platform) called the Australian Parkinson’s Mission (APM), with results from the first set of trials expected in early 2025. Approaches and data are being harmonized across platforms, with learnings shared between countries. An impressive example of global collaboration among researchers and our non-profit partners, and one we would love to emulate in Aotearoa.
The International Parkinson and Movement Disorder Society meeting was a fabulous update on the latest in clinical practice and research with some excellent sessions and valuable discussions. Progress is being made in many different areas of research relating to Parkinson’s, but some of the highlights (for Daniel) were:
All in all, a couple of great meetings with some fabulous opportunities to catch up with leading international researchers and our non-profit partners. Perhaps next year we can bring a New Zealand-developed compound to the iLCT meeting or commit to a clinical trial of a promising new drug. We are only limited by the funding we can raise.