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000267500 1001_ $$aHutchison, R Matthew$$b0
000267500 245__ $$aCinpanemab in Early Parkinson Disease: Evaluation of Biomarker Results From the Phase 2 SPARK Clinical Trial.
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000267500 520__ $$aSensitive, reliable, and scalable biomarkers are needed to accelerate the development of therapies for Parkinson disease (PD). In this study, we evaluate the biomarkers of early PD diagnosis, disease progression, and treatment effect collected in the SPARK.Cinpanemab is a human-derived monoclonal antibody binding preferentially to aggregated forms of extracellular α-synuclein. SPARK was a randomized, double-blind, placebo-controlled, phase 2 multicenter trial evaluating 3 cinpanemab doses administered intravenously every 4 weeks for 52 weeks with an active treatment dose-blind extension period for up to 112 weeks. SPARK enrolled 357 participants diagnosed with PD within 3 years, aged 40-80 years, ≤2.5 on the modified Hoehn and Yahr scale, and with evidence of striatal dopaminergic deficit. The primary outcome was change from baseline in the Movement Disorder Society-Sponsored Revision of the Unified Parkinson's Disease Rating Scale total score. Secondary and exploratory biomarker outcomes evaluated change from baseline at week 52 relative to placebo. Dopamine transporter SPECT and MRI were used to quantify changes in the nigrostriatal dopamine pathway and regional atrophy. CSF and plasma samples were used to assess change in total α-synuclein levels, α-synuclein seeding, and neurofilament light chain levels. SPARK was conducted from January 2018 to April 2021 and terminated due to lack of efficacy.Approximately 3.8% (15/398) of SPECT-imaged participants did not have evidence of dopaminergic deficit and were screen-failed. Binary classification of α-synuclein seeding designated 93% (110/118) of the enrolled CSF subgroup as positive for α-synuclein seeds at baseline. Clinical disease progression was observed, with no statistically significant difference in cinpanemab groups compared with that in placebo. Ninety-nine percent of participants with positive α-synuclein seeding remained positive through week 52. No statistically significant changes from baseline were observed between treatment groups and placebo across biomarker measures. Broadly, there was minimal annual change with high interindividual variability across biomarkers-with striatal binding ratios of the ipsilateral putamen showing the greatest mean change/SD over time.Biomarker results indicated enrollment of the intended population with early PD, but there was no significant correlation with disease progression or clear evidence of a cinpanemab treatment effect on biomarker measures. Suitable biomarkers for evaluating disease severity and progression in early PD trials are still needed.NCT03318523 (clinicaltrials.gov/ct2/show/NCT03318523); Submitted October 24, 2017; First patient enrolled January 2018.
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000267500 650_7 $$2NLM Chemicals$$aalpha-Synuclein
000267500 650_7 $$2NLM Chemicals$$aAntiparkinson Agents
000267500 650_7 $$2NLM Chemicals$$aAntibodies, Monoclonal
000267500 650_7 $$0VTD58H1Z2X$$2NLM Chemicals$$aDopamine
000267500 650_7 $$2NLM Chemicals$$aBiomarkers
000267500 650_2 $$2MeSH$$aHumans
000267500 650_2 $$2MeSH$$aParkinson Disease: diagnostic imaging
000267500 650_2 $$2MeSH$$aParkinson Disease: drug therapy
000267500 650_2 $$2MeSH$$aalpha-Synuclein
000267500 650_2 $$2MeSH$$aAntiparkinson Agents: therapeutic use
000267500 650_2 $$2MeSH$$aAntibodies, Monoclonal: therapeutic use
000267500 650_2 $$2MeSH$$aDopamine: metabolism
000267500 650_2 $$2MeSH$$aBiomarkers
000267500 650_2 $$2MeSH$$aDisease Progression
000267500 650_2 $$2MeSH$$aDouble-Blind Method
000267500 7001_ $$aFraser, Kyle$$b1
000267500 7001_ $$aYang, Minhua$$b2
000267500 7001_ $$aFox, Tara$$b3
000267500 7001_ $$aHirschhorn, Elizabeth$$b4
000267500 7001_ $$aNjingti, Edwin$$b5
000267500 7001_ $$00000-0002-8054-7502$$aScott, David$$b6
000267500 7001_ $$aBedell, Barry J$$b7
000267500 7001_ $$aKistner, Kristi M$$b8
000267500 7001_ $$aCedarbaum, Jesse M$$b9
000267500 7001_ $$aEvans, Karleyton C$$b10
000267500 7001_ $$aGraham, Danielle$$b11
000267500 7001_ $$aMartarello, Laurent$$b12
000267500 7001_ $$0P:(DE-2719)9001340$$aMollenhauer, Brit$$b13
000267500 7001_ $$00000-0003-1229-3667$$aLang, Anthony E$$b14
000267500 7001_ $$aDam, Tien$$b15
000267500 7001_ $$aBeaver, John$$b16
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