Safety and Tolerability of Active Immunotherapy Targeting α-Synuclein with PD03A in Patients with Early Parkinson's Disease: A Randomized, Placebo-Controlled, Phase 1 Study.

Werner Poewe, Dieter Volc, Klaus Seppi, Rossella Medori, Petra Lührs, Alexandra Kutzelnigg, Atbin Djamshidian, Caroline Thun-Hohenstein, Wassilios G Meissner, Olivier Rascol, Achim Schneeberger, Günther Staffler, Werner Poewe, Klaus Seppi, Atbin Djamshidian, Roberto deMarzi, Beatrice Heim, Stephanie Mangesius, Raphaela Stolz, Katarzyna Wachowicz, Dieter Volc, Caroline Thun-Hohenstein, Constanze Riha, Achim Schneeberger, Vera Bürger, Gergana Galabova

Journal: Journal of Parkinson's disease 2022;11(3):1079-1089

PMID: 34092654

Abstract

BACKGROUND

Immunotherapies targeting α-synuclein aim to limit its extracellular spread in the brain and prevent progression of pathology in Parkinson's disease (PD). PD03A is a specific active immunotherapy (SAIT) involving immunization with a short peptide formulation.

OBJECTIVE

This phase 1 study characterized the safety and tolerability of PD03A in patients with early PD. A key secondary objective was to evaluate immunological activity following immunization.

METHODS

This was a phase 1 study of two different doses of PD03A versus placebo in PD patients. Patients were randomized (1:1:1) to receive four priming plus one booster vaccination of PD03A 15μg, PD03A 75μg or placebo and were followed for 52 weeks.

RESULTS

Overall, 36 patients were randomized, of which 35 received five immunizations and completed the study. All patients experienced at least one adverse event. Transient local injection site reactions affected all but two patients; otherwise most AEs were considered unrelated to study treatment. A substantial IgG antibody response against PD03 was observed with a maximum titer achieved at Week-12. Differences in titers between both active groups versus placebo were statistically significant from the second immunization at Week-8 until Week-52.

CONCLUSION

The safety profile and positive antibody response of PD03A supports the further development of active immunotherapeutic approaches for the treatment of PD.

Address: Department of Neurology, Medical University Innsbruck, Innsbruck, Austria.; PROSENEX Study Center at Privatklinik Confraternitaet, Vienna, Austria.; AFFiRiS AG, Vienna, Austria.; Service de Neurologie, CRMR Atrophie Multisystématisée, CHU Bordeaux and Université Bordeaux, CNRS, IMN, UMR 5293, F-33000 Bordeaux, France.; Toulouse Parkinson Expert Center, Departments of Neurosciences and Clinical Pharmacology, Centre d'Investigation Clinique de Toulouse CIC1436, NS-Park/FCRIN Network, and NeuroToul COEN Center, University Hospital of Toulouse, INSERM, University of Toulouse, Toulouse, France.; AFFiRiS AG, Vienna, Austria.; Accanis GmbH, Vienna, Austria.
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