Note: The update provided below is for informational purposes only. Any treatments described are still in experimental stages and have not been approved by Health Canada. Please speak with your doctor for any questions regarding your treatment plan. 

New therapies progress through the clinical trials testing pipeline each year with the goal of improving the quality of life for people with Parkinson’s and, ultimately, finding a cure. An overview of the current clinical trials pipeline for Parkinson’s was recently published and we are here to summarize the key highlights. For a refresher on clinical trials and what happens in each phase, here is a helpful FAQ. 

Of the drugs currently being tested, seventy-six (55%) were geared for symptom management (ST), and sixty-three (45%) were disease-modifying therapies (DMTs), aimed at altering the course of Parkinson’s disease progression – an upgrade from 55 DMTs last year. 

Phases of Trials 

As of June 2023, there are nearly 139 Parkinson’s therapies active in the clinical trial pipeline: 

• 47 products in Phase I 
• 72 products in Phase II
• 20 products in Phase III 

There’s a range of drugs to treat Parkinson’s at various stages of the trial pipeline. The road ahead is looking positive with numerous therapeutic options being added every year.  

Of the 47 treatments included in the Phase I pipeline, there was almost a 50/50 split between disease-modifying agents and symptom-management therapies.  

While many of the treatments in 2023 clinical trials are novel drugs being tested, most Phase II trials are repurposed drugs, meaning researchers use drugs that have already been approved to treat one condition and test this drug for the treatment of Parkinson’s. One huge advantage of drug repurposing is the safety of the drug has already been established, eliminating the need to start from scratch which would be more costly and take much longer. There are currently a total of 72 products in Phase II trials, with 35% being repurposed drugs, including a drug that was initially used as an anti-epileptic and is now being repurposed for Parkinson’s. 

Within the Phase III pipeline, there are 20 products with the majority (14 trials) being symptom management drugs. Overall, most of the trials involving novel agents launched in either Phase I or II but it was exciting to see four trials graduate to Phase III including three DMTs.  

Disease-modifying therapies (DMTs)

Since 2020, the proportion of DMT trials has risen from 39.3% to 45.3%. We see a wide range of therapeutic targets within the DMT category – from therapies aimed at genetic forms of Parkinson’s, to medications focused on the accumulation of the Parkinson’s protein alpha-synuclein, to probiotics for gut health. In 2023, we see increased activity in the cell therapy space with six stem cell trials. The increased spotlight on stem cell therapy in recent years represents a shift in the therapeutic landscape and offers another avenue to potentially stop or slow the progression of Parkinson’s. 

Excitingly, three DMT trials in Phase III are scheduled to be completed by the end of 2023.  

Phase 3 DMT trials completing in 2023: 

• Memantine: Alzheimer’s drug that aims to reduce cognitive impairment in Parkinson’s. 
• Ganoderma/Lingzh: Mushrooms from traditional Chinese medicine are being studied for their potential to slow the progression of Parkinson’s symptoms. 
• Buntanetap: Reduces the production of alpha-synuclein with the goal of improving motor symptoms of Parkinson’s.  

Symptom therapies and their targets 

*Numbers in brackets indicate the number of trials focused on this symptom in the 2023 pipeline 

Of the 76 active trials for symptom management, the majority were targeted toward the management of motor symptoms (22 trials). Although some drugs (17 trials), targeted the combination of motor and non-motor symptoms, it’s clear we need to see more efforts towards the management of non-motor symptoms. Additionally, people living with Parkinson’s have expressed the desire for more drugs to combat the tremor symptom in the earlier stages. 

Conclusion 

In 2023, there are 89 trials with a completion date set for the end of the year. The increasing number of trials in the pipeline highlights the efforts of the Parkinson’s community, and the resilience and determination to produce more rigorous science in the face of a global pandemic. There is much to be excited about, and we look forward to the updates the year will bring.