Safety and tolerability of intracerebroventricular PDGF-BB in Parkinson's disease patients

J Clin Invest. 2015 Mar 2;125(3):1339-46. doi: 10.1172/JCI79635. Epub 2015 Feb 17.

Abstract

BACKGROUND. Recombinant human PDGF-BB (rhPDGF-BB) reduces Parkinsonian symptoms and increases dopamine transporter (DAT) binding in several animal models of Parkinson's disease (PD). Effects of rhPDGF-BB are the result of proliferation of ventricular wall progenitor cells and reversed by blocking mitosis. Based on these restorative effects, we assessed the safety and tolerability of intracerebroventricular (i.c.v.) rhPDGF-BB administration in individuals with PD. METHODS. We conducted a double-blind, randomized, placebo-controlled phase I/IIa study at two clinical centers in Sweden. Twelve patients with moderate PD received rhPDGF-BB via an implanted drug infusion pump and an investigational i.c.v. catheter. Patients were assigned to a dose cohort (0.2, 1.5, or 5 μg rhPDGF-BB per day) and then randomized to active treatment or placebo (3:1) for a 12-day treatment period. The primary objective was to assess safety and tolerability of i.c.v.-delivered rhPDGF-BB. Secondary outcome assessments included several clinical rating scales and changes in DAT binding. The follow-up period was 85 days. RESULTS. All patients completed the study. There were no unresolved adverse events. Serious adverse events occurred in three patients; however, these were unrelated to rhPDGF-BB administration. Secondary outcome parameters did not show dose-dependent changes in clinical rating scales, but there was a positive effect on DAT binding in the right putamen. CONCLUSION. At all doses tested, i.c.v. administration of rhPDGF-BB was well tolerated. Results support further clinical development of rhPDGF-BB for patients with PD. TRIAL REGISTRATION. Clinical Trials.gov NCT00866502. FUNDING. Newron Sweden AB (former NeuroNova AB) and Swedish Governmental Agency for Innovation Systems (VINNOVA).

Publication types

  • Clinical Trial, Phase I
  • Clinical Trial, Phase II
  • Multicenter Study
  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Antiparkinson Agents / administration & dosage*
  • Antiparkinson Agents / adverse effects
  • Becaplermin
  • Dopamine Plasma Membrane Transport Proteins / metabolism
  • Double-Blind Method
  • Humans
  • Injections, Intraventricular
  • Male
  • Middle Aged
  • Parkinson Disease / drug therapy*
  • Protein Binding
  • Proto-Oncogene Proteins c-sis / administration & dosage*
  • Proto-Oncogene Proteins c-sis / adverse effects
  • Putamen / drug effects
  • Putamen / metabolism
  • Treatment Outcome

Substances

  • Antiparkinson Agents
  • Dopamine Plasma Membrane Transport Proteins
  • Proto-Oncogene Proteins c-sis
  • Becaplermin

Associated data

  • ClinicalTrials.gov/NCT00866502