The randomized trial results are in for the GLP-1 drug Exenatide for Parkinson's disease. Spoiler: NO symptomatic or disease modifying effect. Tom @foltynie @DavidStandaert and I interviewed in the @nytimes @ginakolata on the latest paper just published in @TheLancet by Tom and his colleagues. Key Points: - 'Rigorous' study randomly assigned Parkinson’s folks to take exenatide (a relative of Ozempic). - 194 folks enrolled in the UK. - "No benefit or slowing of the course of Parkinson's after 96 weeks." - "No effect on patient symptoms, no effect on brain scans, no subgroup that showed any benefit. No matter how the researchers sliced the data the results were the same." My take: “This is a sobering moment. This is a really well done study, and it came up empty-handed.” Animal studies and small human studies previously suggested benefit. Another recent smaller study of a similar drug, lixisenatide, in the @NEJM was positive. “Researchers started digging into claims databases...and asked if patients who had taken GLP-1s might be less likely to get Parkinson’s or, if they had it, would have a disease that progressed more slowly...the results were promising." "They looked at epidemiological studies. They found that people with diabetes who took GLP-1s were less likely to have Parkinson’s." When the first study came out Gina quoted me as saying we were “nibbling at the edges of disease modification.” We were however all humbled and this reminds us how important it is to do the science, and not to rush to market or judgement. Dave commented that “he wouldn’t do another study like this unless you learn what is the target...what is the biochemistry you are trying to change in the brain? How do these drugs work, anyway?” Good science means replication. Good science protects the public and in the case of GLP-1s, there can be associated weight loss and loss of muscle mass, and that is something we probably want to avoid in Parkinson's. Ab uno disce omnes – from this one example we learn (all the rest). Let's stay humble, but keep learning and advancing the science for the benefit of those w/ Parkinson's and beyond. thelancet.com/journals/lance… NYTimes article: nytimes.com/2025/02/04/healt… #Parkinsons #GLP1 #ozempic #diabetes