On 2015 Jul 25, David Keller commented:

This just in: pioglitazone proved futile for slowing the progression of Parkinson's disease

A large double-blind placebo-controlled randomized phase II study has proved pioglitazone futile for slowing the progression of early Parkinson's disease [1]. Pioglitazone is the only widely-prescribed thiazolidinedione ("glitazone") since the FDA placed safety restrictions on the use rosiglitazone (Avandia).

Glitazones now join the ranks of disproved neuro-protectants, including creatine, co-enzyme Q10, vitamin E and minocycline. Back to the laboratory....

Reference:

1: NINDS Exploratory Trials in Parkinson Disease (NET-PD) FS-ZONE Investigators. Pioglitazone in early Parkinson's disease: a phase 2, multicentre, double-blind, randomised trial. Lancet Neurol. 2015 Aug;14(8):795-803. doi: 10.1016/S1474-4422(15)00144-1. Epub 2015 Jun 23. PubMed PMID: 26116315.

On 2015 Jul 23, David Keller commented:

Exenatide, a different kind of diabetes drug, also exhibits activity against Parkinson's disease

The type-2 diabetes drug exenatide is in the category of incretin mimetics, and is not a thiazolidinedione ("glitazone") like the drugs in this study by Brauer and colleagues. Exenatide lowers blood sugar by raising levels of endogenous insulin, among other effects. It also has exhibited symptomatic benefits in Parkinson's disease, in a prospective randomized interventional trial [1], with persistent motor and cognitive benefits which suggest possible disease modification. Exenatide can be used concomitantly with glitazones, and such use should be accounted for in this glitazone study, to avoid skewed results. For example, if the percentage of glitazone patients taking exenatide was higher than the percentage of placebo patients taking exenatide, then the apparent benefits of glitazone use may have been all or partly due to this imbalance in the use of exenatide. Was this possibility controlled for?

Reference:

1: Aviles-Olmos I, Dickson J, Kefalopoulou Z, Djamshidian A, Kahan J, Ell P, Whitton P, Wyse R, Isaacs T, Lees A, Limousin P, Foltynie T. Motor and cognitive advantages persist 12 months after exenatide exposure in Parkinson's disease. J Parkinsons Dis. 2014;4(3):337-44. doi: 10.3233/JPD-140364. PubMed PMID: 24662192.

On 2015 Jul 23, David Keller commented:

Exenatide, a different kind of diabetes drug, also exhibits activity against Parkinson's disease

The type-2 diabetes drug exenatide is in the category of incretin mimetics, and is not a thiazolidinedione ("glitazone") like the drugs in this study by Brauer and colleagues. Exenatide lowers blood sugar by raising levels of endogenous insulin, among other effects. It also has exhibited symptomatic benefits in Parkinson's disease, in a prospective randomized interventional trial [1], with persistent motor and cognitive benefits which suggest possible disease modification. Exenatide can be used concomitantly with glitazones, and such use should be accounted for in this glitazone study, to avoid skewed results. For example, if the percentage of glitazone patients taking exenatide was higher than the percentage of placebo patients taking exenatide, then the apparent benefits of glitazone use may have been all or partly due to this imbalance in the use of exenatide. Was this possibility controlled for?

Reference:

1: Aviles-Olmos I, Dickson J, Kefalopoulou Z, Djamshidian A, Kahan J, Ell P, Whitton P, Wyse R, Isaacs T, Lees A, Limousin P, Foltynie T. Motor and cognitive advantages persist 12 months after exenatide exposure in Parkinson's disease. J Parkinsons Dis. 2014;4(3):337-44. doi: 10.3233/JPD-140364. PubMed PMID: 24662192.

On 2015 Jul 25, David Keller commented:

This just in: pioglitazone proved futile for slowing the progression of Parkinson's disease

A large double-blind placebo-controlled randomized phase II study has proved pioglitazone futile for slowing the progression of early Parkinson's disease [1]. Pioglitazone is the only widely-prescribed thiazolidinedione ("glitazone") since the FDA placed safety restrictions on the use rosiglitazone (Avandia).

Glitazones now join the ranks of disproved neuro-protectants, including creatine, co-enzyme Q10, vitamin E and minocycline. Back to the laboratory....

Reference:

1: NINDS Exploratory Trials in Parkinson Disease (NET-PD) FS-ZONE Investigators. Pioglitazone in early Parkinson's disease: a phase 2, multicentre, double-blind, randomised trial. Lancet Neurol. 2015 Aug;14(8):795-803. doi: 10.1016/S1474-4422(15)00144-1. Epub 2015 Jun 23. PubMed PMID: 26116315.