EAN 2025 | What is on the horizon for the treatment of Parkinson’s disease?

In this Congress I have been asked to predict the future. So my lecture was on future treatments in Parkinson’s disease. I would say that there are many interesting things, you know, ongoing. You know, new cell therapies with stem cell neurons. Clearly, new data is being generated in gene therapies, even using complex gene therapies in subgroups of patients that have a genetic cause for their disease; this is really innovative and new. I would say that there are new trials that will start, but even with the alpha-synuclein antibodies, but it’s important to say that those trials that are starting – in the best scenario, if they are positive – this will mean a new drug on the market in five years, probably. I would say that what is most interesting is the concept regarding the best medical treatment for PD is changing. And in my view, what we should call now the best medical treatment for Parkinson’s disease is a combination of using all available medicines for which we have data regarding efficacy to treat all symptomatic problems, from constipation to motor impairment, and we should add exercise, we should add socialization, and we should add, you know, interdisciplinary care, meaning bringing the physiotherapists, the speech therapists, the nutritionists, and the psychologists to help in the management of PD, and not forget using technology. I would say that technology probably may be extremely useful, first in facilitating the communication between the different partners, I would say the different health professionals, but also bringing something that may be new. That is, I think we are at the stage where we can have, like, real-time adjustment in the management based on, you know, detecting not just what is happening in the brain, but also in the periphery, in the movement, in the way we behave. And I’m pretty sure that technology can help, not just, you know, in very sophisticated techniques like what we now call closed-loop deep brain stimulation, meaning detecting activity in the brain and changing the way we stimulate the brain, but also detecting the way we move and influencing, for instance, the way we infuse levodopa subcutaneously in the body of our patients. So I think we are in an interesting corner, probably not to start very, I would say, sophisticated treatments, but at least changing the paradigm of the best way to treat Parkinson’s disease patients.

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