Could the diabetes drug glitazone be used to prevent Parkinson’s disease?

A study published just 2 days ago in PLOS Medicine showed that the pathway targeted by glitazone diabetes drugs might be a target for preventing Parkinson’s disease.

Parkinson’s is a relatively common, slowly progressive nervous system disease caused by gradual loss of nerve cells producing dopamine, which controls body movements. When %60 to %80 of these cells are lost, insufficient dopamine is produced and symptoms appear. Although possible in younger people, average onset is around 60. Parkinson’s does not directly cause death but seriously affects life through tremor, slowed movements, muscle stiffness, unstable walking, sleep problems, constipation, loss of smell and a serious-looking, masked face. No treatment yet eliminates the disease. Loss of dopamine-producing cells cannot yet be stopped, so progression cannot be prevented. Medicines attempt to replace dopamine only to relieve symptoms. Prevention is therefore an important research focus. One study published 2 days ago in PLOS Medicine found reduced Parkinson’s risk with glitazones, making their PPAR gamma pathway an important prevention target.

Glitazones are oral medicines for type 2 diabetes. They reduce insulin resistance and enhance insulin action, increasing cellular glucose consumption. Their risk of hypoglycemia is low, and they support HDL, the good cholesterol. Disadvantages include increased heart attack risk and some weight gain, averaging 2-5 kg. They are therefore not preferred in people with heart failure or high risk of it. Acting through PPAR gamma, they are a good option for suitable patients. Laboratory and animal studies also showed nerve-cell protection. This suggested possible Parkinson’s prevention, prompting comparison of its incidence in diabetes patients taking glitazones versus other diabetes medicines.

The study evaluated 45 thousand glitazone users and 120 thousand users of other diabetes drugs, 165 thousand diabetes patients in total, followed for approximately 14 years. Parkinson’s was diagnosed in 175 glitazone users versus 571 taking other drugs, a significantly lower incidence among glitazone users.

In conclusion, According to this study, glitazone diabetes drugs may somewhat reduce Parkinson’s risk. However, because of potentially serious side effects, they cannot be used in healthy people to reduce Parkinson’s risk or for investigational purposes. The study’s main importance is therefore identifying PPAR gamma as a potential drug target for future research and offering hope for prevention.