Effects of Angiotensin Type 1 Receptor Antagonists on Parkinson?s Disease Progression: an exploratory study in the PPMI database

UDOVIN, LUCAS; OTERO-LOSADA, MATILDE; BORDET, SOFIA; CHEVALIER, GUENSON; QUARRACINO, CECILIA; CAPANI, FRANCISCO; PEREZ LLORET, SANTIAGO

Congreso; 25th International Congress of Parkinson?s Disease and Movement Disorders; 2021

The objective of this study is to analyze the effect of exposure to AT1 receptor blockers (ARBs) and angiotensinconverting enzyme inhibitors (ACEIs) on the clinical progression of parkinson's disease (PD) of newly diagnosed PD patients from the Parkinson?s Progress Marker Initiative (PPMI) study database.Parkinson?s disease (PD) is the second leading neurodegenerative disorder after Alzheimer?s [1]. The many advances in the pathophysiology of PD have not yielded either preventing or progression-retarding treatments. The reninangiotensin system (RAS) in the brain was reported in regulating dopaminergic neurotransmission and neuron survival. Angiotensin II AT1 receptor blockers (ARBs) and the angiotensin-converting enzyme inhibitors (ACEIs) prevented neuronal damage caused by dopaminergic neurotoxins in experimental PD cellular and animal models [2]. Furthermore, perindopril, an ACEI, reduced the latency of the motor response to L-DOPA and increased ?on? periods during the waking day in a small double-blind, randomized, cross-over study [3]. We analyzed data of the Parkinson?s Progression Markers Initiative (PPMI) study and evaluated the potential effects of ARBs and ACEIs on disease progression in PD patients.We included 423 newly diagnosed PD patients, free from antiparkinsonian treatment, from the PPMI. We compared the proportion of patients starting on L-DOPA during the first year of follow-up, and the changes in MDS-UPDRS total score and sub-scores during the first five follow-up years for patients exposed or not to ARBs or ACEIs.Treatment with ARBs did not affect the proportion of patients on L-DOPA during the first year, (adjusted OR, 95% CI=0.26, 0.03-2.18, p=0,52), while reduced MDS-UPDRS total score during the follow-up in patients (0.85, 0.76-0.95, p