Emerging therapies expected to make a difference in Parkinson's disease management.

Abstract

Recent advances in Parkinson's disease (PD) therapeutics have generated new opportunities for both symptomatic and disease-modifying treatments. This review discusses four therapeutic approaches that are likely to influence PD management in the coming years: continuous subcutaneous levodopa infusion, cell-based dopamine replacement, immunotherapies targeting α-synuclein, and gene transfer therapies. Subcutaneous levodopa infusion systems have recently demonstrated efficacy in reducing motor fluctuations and represent an important advance toward more physiological dopamine replacement. Stem cell-derived dopaminergic progenitors have revitalized cell replacement research and demonstrated encouraging safety and feasibility in early clinical trials. Although first-generation anti-α-synuclein antibodies have not demonstrated definitive clinical benefit, advances in antibody engineering and biomarker-guided patient selection may help clarify their therapeutic potential. Improvements in viral vector design and delivery are enabling increasingly sophisticated gene-based therapies for both sporadic and genetics forms of PD. Collectively, these advances are expanding therapeutic options and shaping the future management of PD.