Is the anticoagulant "Dabigatran" relevan... - Cure Parkinson's

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Is the anticoagulant "Dabigatran" relevant to PD? Perhaps, but with some serious drawbacks

sharoncrayn profile image
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Interesting that the anticoagulant drug Dabigatran (PRADAXA) is getting press for the recent mice study which showed little to no memory loss in ALZ mice over a 12 month study period.

When you think about both diseases, the transition to PD seems possible since ALZ and PD share many of the same, if not identical, characteristics of brain degeneration. In the study, Dabigatran inhibited thrombin and abnormal deposition of fibrin in the brain thus apparently improving cerebral circulation...including reducing significantly cerebral inflammation, blood vessel injury, and amyloid protein plaques. Downside not mentioned with the mice is the increased risk of INTER-CRANIAL bleeding...potentially seriously (black box drug).

It is a mice study, but far more interesting than most because it actually employs a "repurposed" drug already on the market and deals directly with a critical piece of the puzzle, which is cerebral circulation. Downside? it is a black box warning drug so it is questionable for anyone in their 70s or older, which is a huge chunk of PD patients.

Round and round we go.

Sharon

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sharoncrayn
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reedboat2 profile image
reedboat2

Inter-cranial bleeding is a pretty serious complication. My dad died from the results of a hemorrhagic stroke, so I am very familiar with that one. Not good.

MarionP profile image
MarionP

This kind of intracranial bleed is a significant risk for elders because the blood and various components essentially attacks cells around it when it gets outside its vasculature. You only want to use clot inhibitors to the dose and extent that it is more important to control clotting for cardiovascular and related stroke type events, while limiting the bleed risk to minimum practical or in keeping with the risk being reasonably below the reward; and would also be therefore quite important that the decision process be strongly influenced by the expertise of a cardiovascular specialist. I would think it would call for a quite delicate sense of balance. Just the worry of knowing about it might have me stressed enough to produce more oxidating radicals from that stress alone.

On top of that is the risk of macular bleeding. There are located the most tiny, delicate arteries in your who body, supplying oxygen and other needs to the cells of the macula. They are, as are all arteries, subject to aging and hardening (from drying with aging and from gradual accumulation of placques similar to any arteries) which leads to eventual potential blood leakage and macular degeneration, risking the nasty "wet" form of macular degeneration. Such degeneration can occur on the micro level and accumulate over time, with vision decay either gradually or quickly deteriorating without immediate notice until permanent damage occurs. As placque and any other impediments affect the arteries, the risk of blood pressure changes increase, and with them, the risk of bleeding in those tiny arteries that are, because of their tiny size, among the most vulnerable to bleeding as they age, harden, and become that much more sensitive to increased blood pressure. Any bleeding unimpeded by anti-clotting medication could render vision under considerable threat. Thus, one would have to have a new partner to the picture if using such a product for PD: an ophthalmologist, consulted early and probably often.

Imagine having PD and a significant stroke or dementia risk, and a potential macular bleed, as a side effect in a population for which those risks are almost a standard aging component, regardless of other co-occurring conditions...I say "other" because it is sometimes very true to consider aging as a "condition" all by itself. That's a lot to expect from Phase I safety testing, and it would take some great confidence by a physician to consider prescribing it off-label, as would have to be the case without FDA approval for PD. There might be more promising avenues to look to.

sharoncrayn profile image
sharoncrayn in reply to MarionP

Very good summary of why it probably won't make it to being approved.

Sharon

hilary_galbraith profile image
hilary_galbraith

Llll0lllllll

sharoncrayn profile image
sharoncrayn in reply to hilary_galbraith

Unfortunately, some PD patients are willing to try anything.

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