Department of Neurology, School of Medicine, Klinikum rechts der Isar, Technical University of Munich, Ismaninger Straße 22, 81675, Munich, Germany.
German Center for Neurodegenerative Diseases (DZNE), Munich, Germany.
J Neural Transm (Vienna). 2023 Jun;130(6):793-820. doi: 10.1007/s00702-023-02641-6. Epub 2023 May 5.
The worldwide prevalence of Parkinson's disease (PD) has been constantly increasing in the last decades. With rising life expectancy, a longer disease duration in PD patients is observed, further increasing the need and socioeconomic importance of adequate PD treatment. Today, PD is exclusively treated symptomatically, mainly by dopaminergic stimulation, while efforts to modify disease progression could not yet be translated to the clinics. New formulations of approved drugs and treatment options of motor fluctuations in advanced stages accompanied by telehealth monitoring have improved PD patients care. In addition, continuous improvement in the understanding of PD disease mechanisms resulted in the identification of new pharmacological targets. Applying novel trial designs, targeting of pre-symptomatic disease stages, and the acknowledgment of PD heterogeneity raise hopes to overcome past failures in the development of drugs for disease modification. In this review, we address these recent developments and venture a glimpse into the future of PD therapy in the years to come.
在过去的几十年中,帕金森病(PD)的全球患病率一直在不断上升。随着预期寿命的提高,PD 患者的疾病持续时间更长,进一步增加了对适当 PD 治疗的需求和社会经济重要性。如今,PD 主要通过多巴胺能刺激进行对症治疗,而改变疾病进展的努力尚未转化为临床实践。已批准药物的新配方和晚期运动波动的治疗选择以及远程医疗监测的应用改善了 PD 患者的护理。此外,对 PD 疾病机制的理解不断加深,导致确定了新的药理学靶点。应用新的试验设计,针对疾病早期阶段,并承认 PD 的异质性,有望克服过去在开发疾病修饰药物方面的失败。在这篇综述中,我们探讨了这些最新进展,并对未来几年 PD 治疗的未来进行了展望。