Trial Treatments

The treatments were chosen after carefully looking at all the available evidence that has been published about them. We looked at evidence about their safety, as well as evidence from other clinical studies. People with Parkinson’s and care partners were involved in the discussions and advised on what would be acceptable to participants. We believe these treatments could be the most promising treatments to slow or stop PD symptoms from getting worse.

The trial treatments currently being tested in the EJS ACT-PD trial are:

• Group A: Placebo (or dummy drug) 

• Group B: Telmisartan (40mg per day) 

• Group C: Terazosin (5mg per day)

This trial design also allows us to add new treatments in new treatment groups whilst the trial is ongoing, rather than needing to set up a new trial.

The treatments being tested in the EJS ACT-PD trial were chosen through a careful process involving our Treatment Selection Working Group, people with Parkinson’s, and carers / partners. Over 200 possible treatments were reviewed by looking at scientific evidence, how they might work in Parkinson’s, how safe they are, and whether they could be tested in a large clinical trial in the UK.

The treatments are repurposed medicines, meaning they are already used to treat other conditions. This means we already understand their safety and possible side effects.

Telmisartan:

Current use: Telmisartan is used to treat high blood pressure and help prevent heart and blood vessel problems.

Rationale for use in Parkinson's: Scientific research suggests that Telmisartan helps to reduce inflammation in the brain and protect the nerve cells that make dopamine. This is important as we know that dopamine levels are lower in people with Parkinson’s. Compared with similar medicines, telmisartan may reach the brain more effectively and remain there for longer, which could increase its ability to slow Parkinson’s progression. Large population studies have also found that people taking telmisartan or similar drugs may be less likely to develop Parkinson’s.

Previous study results: A clinical trial of candesartan (a drug from the same group as telmisartan) showed improvements in both movement and non-movement symptoms and quality of life in people with Parkinson’s. You can read about this trial here.

Terazosin:

Current use: Terazosin is used to treat high blood pressure and symptoms of an enlarged prostate.

Rationale for use in Parkinson's: Scientific research shows that terazosin may improve energy production in the brain cells that make dopamine, which helps to protect them. This is important as we know that dopamine levels are lower in people with Parkinson’s. Large population studies also suggest that people taking terazosin or similar medicines may be less likely to develop Parkinson’s, and those who already have the condition may have slower symptom progression.

Previous study results: Clinical trials in people with Parkinson’s taking terazosin have shown improvements in movement symptoms and signs that the drug is working in the brain. You can read about one of these studies here.