Old Drugs – New Cures?

From James Beck, Ph.D., Vice President of Scientific Affairs

Using old drugs as new cures seems like a surefire winner. It may be. However, after attending a recent meeting outside London hosted by the Cure Parkinson’s Trust, a small yet impactful British charity, it is clear that this path is neither clear nor easy. A committee of experts at the meeting evaluated and prioritized dozens of existing compounds – many are drugs used to treat other diseases – based upon their potential to stop Parkinson’s disease.

From left, James Beck, Tom Isaacs, and Steven DeWitte at
Cure Parkinson's Trust meeting at Cumberland Lodge.

Repurposing drugs for a new use like this has the potential to shave significant time from the drug development process for Parkinson’s. But existing drugs come with existing problems. And these problems cannot always be overcome. For instance, a recent science article covered by PDF suggested that a chemotherapeutic agent, nilotinib, might be useful for treating PD. However, it is not clear what the proper dose should be (the article suggested a low one would be effective). Moreover, with potential side effects that include sudden death, the committee felt it was not ethical to consider placing people living with PD in potential danger.

Still, there are drugs that appear to be safe and well tolerated, like statins used to lower cholesterol and metformin used for type II diabetes to name a few. These drugs are not chosen at random: By surveying thousands of people, epidemiology studies have been able to link drugs people take for other conditions (like these) with a lower risk of developing PD. There are also data from laboratory studies that suggest how these types of drugs may help. Even here, though, the path forward is not so clear. The mechanism of action, that is how might some of these drugs actually affect PD in people, is not known. This is not always a stumbling block; but when combined with drugs that are likely to have modest effects and low odds of success, it can be a problem, especially with limited resources.

Recognizing these issues, the Trust’s prioritization committee took a hard look at each potential drug candidate and recommended a handful as most promising. These few culled from a list of two dozen compounds will now advance towards evaluation in clinical trials. Hopefully, that phase will begin soon.

Dr. Bill Weiner: Eminent Scientist, Independent Voice and True Friend

Last month, the Parkinson's community lost a dear member, one who dedicated his career to the treatment of the disease. William J. "Bill" Weiner, M.D.,  known to many at the University of Maryland where he served as Chairman of Neurology and the Director of the Maryland Parkinson's Disease and Movement Disorders Center, passed away on December 29, 2012.

Involved in treatment trials for Parkinson's disease since levodopa in the 1960s, Bill was truly one of a kind in his profession – a fine scientist and a dedicated clinician who was committed to thinking for himself and to expressing his views fearlessly just as they were, arrived at not through crowd-sourced conventional wisdom but through his own learned, astringent, original, independent analysis.  You always knew where you were with Bill, and that he would give it to you straight, with kindness and yet with humor, and from principle rather than from special interest – his own or any other.

We all are grieving with Bill's family, including his wife Lisa Shulman, a fellow Parkinson's scientist/clinician, and treasuring the memories of the philosopher and teacher we all knew.

Please feel welcome to share any of your memories below.

See 2006 Interview with Dr. Weiner in PDF News & Review

Photo credit: American Academy of Neurology.

The Good, the Bad and the Ugly: Science Reporting in Parkinson’s

Will eating berries lessen your risk of Parkinson’s? What about coffee? What’s the real story on coconut oil? Is deep brain stimulation a miracle surgery?

All of us, whether or not we live Parkinson’s, are faced each day with a barrage of headlines about what might help or harm our health.

After such headlines appear, PDF often receives an influx of inquiries asking:

• Does this new drug/therapy/compound help Parkinson’s?
• Is this new drug a cure? 
• When will this new breakthrough be available?

The Good News
Scientists all over the world are conducting research into Parkinson’s. They are publishing their work in scientific journals and discussing it at meetings, and the media is reporting on it. This means that people touched by Parkinson’s disease have the chance to access the latest information about the disease online. According to this weekend's edition of the New York Times, which references studies by the Pew Research Center, people who aren’t connected to the Internet may actually be missing out on valuable health-related information!

The Bad and the Ugly
Not all sources report responsibly to you. Whether a source uses a sensationalistic headline, or leaves out important facts, they don’t always tell the real story.  For example, a story might report on deep brain stimulation as a helpful treatment, without communicating that the surgery does not stop disease progression. Another might report that smoking is associated with a lesser risk of developing Parkinson's, without telling you that picking up the habit isn't a good idea because more research is needed to understand why.

What Does It Mean?
So if you’re reading these headlines at home, how do you discern between fact and fiction? 

At PDF, part of our job is making sure you have quality information.  One initiative we developed last year was to include a "What Does it Mean?" component to the 50 or so scientific studies we cover each year. At the end of each report we ask “What Does it Mean?” and with the help of medical reviewers, science writers and research staff, we give you our best answer.

Sometimes we tell you that a drug could be available in the next five years. Other times, we let you know that a study was unsuccessful but is valuable for our understanding of Parkinson’s overall. Either way, we try to tell you the truth about how the science might impact your life with PD.

Other Strategies

Here are a few other strategies for assessing health information you find online:

• Ask Your Doctor: If you are seeing a Parkinson’s specialist, they should be very aware of the latest research and be able to explain how it applies to you.
• Evaluate Your Source: Where are you finding your information? Pay attention to who is publishing the information and when they published it. A few years ago, PDF published this article in our newsletter, with tips for evaluating whether a certain website is trustworthy. The Internet has changed, but these tips still apply.
• Call our HelpLine: PDF’s HelpLine is available at (800) 457-6676 or email at info@pdf.org from Monday to Friday, 9:00 AM to 5:00 PM to answer your specific questions about PD or specific news items you read.
• Watch Our PD ExpertBriefings: PDF’s online seminars, including this year’s live series and more than 30 recorded seminars, are led by some of the most trusted experts in the field. Need information on exercise? Find it here. Want to know about experimental medications? We have that too.

What About You?

What's your impression of Parkinson's science in the media? Do you find reporting responsible? Are you confused by the headlines or do you find them clear?

What can PDF to bring you the best information about Parkinson’s disease and the latest scientific findings?

P.S. Click here to see PDF's latest science headlines and scroll down in each one to see our answer to "what does it mean?"