Gennaro Pagano, MD, MSc, PhD, Roche Pharma Research & Early Development, Basel, Switzerland, shares his thoughts on the relevance of immunotherapy as a therapeutic strategy in Parkinson’s disease (PD), emphasizing that more long-term clinical data is necessary before any conclusions can be drawn. Phase II trials of two monoclonal antibodies directed against alpha-synuclein were recently published, both of which failed to meet pre-specified endpoints. One of these trials, PASADENA (NCT03100149), tested the impact of prasinezumab on global progression in PD (MDS-UPDRS). While the overall outcome of the trial was negative, trends towards improvement in MDS-UPDRS total scores or subscores were noted in patients who started prasinezumab treatment straight after enrollment, compared to the delayed-start cohort. Therefore, prasinezumab is now being studied in the larger Phase II randomized, placebo controlled PADOVA study (NCT04777331), in participants with early PD who are on stable symptomatic PD medication. It is hoped that longer-term data from a large-scale trial will shed light on the true value of this agent. The form(s) of alpha-synuclein targeted by different investigational antibodies may also be key to their success, so more insights on the key drivers of progression in early-stage disease will aid the development of future immunotherapies in this space. This interview took place at the AD/PD™ 2023 congress in Gothenburg, Sweden.

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