Prasinezumab is shown to reduce signs of motor deterioration in individuals with Parkinson's who have rapidly progressing disease

[Tripple]

medicalxpress.com/news/2024...

[park_bear]

From the linked article:

"The antibody was recently investigated in 316 patients with early-stage PD in the phase 2 PASADENA clinical trial, but was found to have no meaningful effect on disease progression in this cohort. However, participants in the trial had highly variable disease progression.

Gennaro Pagano and colleagues analyzed the potential effects of prasinezumab on motor progression in four pre-specified subpopulations who had rapidly progressing motor symptoms in the phase 2 PASADENA trial. These rapidly progressing subgroups were defined by the use of monoamine oxidase B (MAO-B) inhibitors at baseline, the staging of their disease on the Hoehn and Yahr scale, the presence of rapid eye movement sleep behavior disorder, or the presence of diffuse malignant phenotypes.

Researchers found that prasinezumab treatment reduced motor symptom worsening in all rapidly progressing subpopulations after 52 weeks, compared with the motor symptoms of those treated with a placebo. This effect was not seen in treated subpopulations characterized as slow progressors."

Subgroup analysis is usually looked upon with great skepticism, because if you slice and dice the data enough you'll always find some portion of the test group that did well. However, pre-specified subgroups avoid this problem, and these were pre-specified. It may also be that the effect was not large enough to be detected in slow progressors.

[Ctime in reply to park_bear]

The clinic that I have done trials at is also doing prasinezumab. As some of those trial arms are now in open label they are comparing patients to it's similar cohort of PPMR data. The staff has commented several times that they believe there is significantly less progression in the prasinezumab cohort. This is not the rapidly progressing or not group as far as I know. I always ask about this study because I was rejected for it!

[sailaway615 in reply to park_bear]

Yeah, park_bear, I think you're right. I was part of the two-year initial trial, and I'm participating in the 5-year follow up. The docs at Vandy opined after the first round that trying to evaluate progression via UPDRS in someone who's early in his/her progression or is otherwise progressing slowly seemed to be too coarse a measurement. If you're measuring when not much is changing anyway, it'll be hard to discern effect on progression. The genesis of the 5-year follow-up seemed to come from the notion that good stuff was happening, but it was going to take a larger swath of time to see the treated group's results separate from the control group. I'm cautiously optimistic, or at least hopeful...