New Study, Clinical Trial, Focus on Early Parkinson's Disease

Two announcements regarding potential treatments for Parkinson's disease and its complications were published during the past week.

In the first, clinical medicine researchers from Keio University School of Medicine in Tokyo, Japan have announced that 2.5 mg of risedronate (Actonel™) plus 1,000 IU (International Units) of vitamin D2 can reduce the incidence of hip fractures in elderly men.

In this study 121 patientsreceived a daily dose of 2.5 mg risedronate and vitamin D2 1,000IU for 2 years, and the remaining 121 received placebo and vitaminD2 1,000 IU. At the end of the study there were 9 hip fractures in the placebo group versus only 3 in the treatment group. Additionally, BMD (bone mineral density) increasedby 2.2% in the risedronate group and decreased by 2.9% in theplacebo group. Both of these findings were statistically significant and indicate that the reported increase in bone density was responsible for the lower incidence of hip fractures.

In the second, the National Institute of Neurological Disorders and Stroke (NINDS, a section of the National Institutes of Health) has announced that it is recruiting volunteers to participate in a Stage III clinical trial involving the possible relationship between the dietary supplement creatine and a slowdown in the rate of progression of Parkinson's disease among those that have been diagnosed with Parkinson's disease within the past five years and who have been treated for two years or less with levodopa or other drugs that increase the levels of dopamine in the brain.

Creatine has been marketed for years as a nutritional supplement and several studies have suggested that it can improve the function of mitochondria, which produce energy inside cells and also may act as an antioxidant that prevents damage from compounds that are harmful to cells in the brain. In a mouse model of PD, creatine is able to prevent loss of the cells that are typically affected. However, the creatine that will be used in this study will be an "enhanced" form, manufactured to meet stricter quality requirements, rather than the less stringent over-the-counter standards.

Comment

It is reported that up to 1 million Americans have Parkinson's disease. It is obvious that any intervention that can slow the clinical progression of the disease or reduce the number of complications directly attributed to Parkinson's would have a significant positive effect on a health care system that is currently struggling to meet the needs of an aging population.

While the two studies mentioned above may seem unrelated at first glance but, when considered in light of previous data related to Parkinson's, they are actually complimentary.

It is well established that loss of mobility leads to loss of bone density which in turn leads to an increase in the number of fractures. If a daily dosage of 2.5 mg of risedronate (Actonel™) can reduce the risk of hip fracture, then the patient can avoid the potential complications (pneumonia, urinary infections, etc) that can arise from the surgical repair of the fracture.

On the other hand, if creatine can delay the progression of Parkinson's disease the patient will benefit from increased mobility and by the reduced number of falls or other accidents.

When the potential impact of both treatments are taken together, they could represent a valuable contribution to the management of early to mid-stage Parkinson's disease.

References / For More Information

NIH Announces Phase III Clinical Trial of Creatine for Parkinson's disease: Nutritional Supplement May Slow Progression of Disease,

http://www.nih.gov/news/pr/mar2007/ninds-22.htm.

Yoshihiro Sato, Yoshiaki Honda and Jun Iwamoto: Risedronate and ergocalciferol prevent hip fracture in elderly men with Parkinson disease, Neurology; 68:911-915 (2007).

A list of institutions participating in the creatine supplement study can be found at http://www.parkinsontrial.ninds.nih.gov/netpd-participate.htm

The National Parkinson's disease Foundation has an extensive web site dealing with Parkinson's http://www.parkinson.org/NETCOMMUNITY/Page.aspx?&pid=201&srcid=-2

Disclaimer

The information presented in this article and its included links is of an informational nature only and is not intended as a recommendation of any changes in the reader's health care program. Before making any changes in diet, medications, or other treatments the reader is strongly advised to consult with their health care provider.