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

LUCAS D. UDOVIN; MATILDE OTERO-LOSADA; SOFIA BORDET; CECILIA QUARRACINO; CAPANI FRANCISCO; SANTIAGO PEREZ-LLORET

Congreso; Movement Disorder (MDS) virtual congress; 2021

The International Parkinson and Movement Disorder Society

Objective: The objective of this study is to analyze the effect of exposure to AT1 receptor blockers (ARBs) and angiotensin-converting 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.Background: 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 renin-angiotensin 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.Method: 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.Results: 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