The Parkinson’s Society of Canada projects that up to 200,000 people in the country will be living with the disease, double the number cited 10 years ago. Part of the reason for the increase is Canada’s aging population, since Parkinson’s usually begins between the ages of 50 and 65. As many as 5-10 percent of patients are under 40; this is a unique condition called Young Onset Parkinson’s.

Hard to diagnose

There is currently no cure, despite ongoing research and development, and the onset of the disease is still not fully understood because it is also difficult to diagnose early. What is known is that it’s caused by dying neurons in the region of the brain that controls movement. This makes symptoms, or “OFF episodes”, generally unpredictable, says Anthony Giovinazzo, President and CEO at Cynapsus Therapeutics Inc.

“The Parkinson’s Society of Canada projects that up to 200,000 people in the country will be living with the disease, double the number cited 10 years ago.”

“It’s a serious rigidity where it’s almost like a complete immobilization. Patients end up having to stand, sit, lay down or be somewhere near a wall, making it extremely difficult to be able to move or talk or do things they normally do,” says Giovinazzo. “We’ve had patients tell us of not being able to drive, go golfing, or even able to work because of these episodes. The real danger is the threat of freezing up, falling, and hitting their head or breaking a hip.”

Unpredictable ‘OFF’ episodes

OFF episodes are triggered by a lack of dopamine in the brain and are broken down into four types. The most common among them is morning akinesia, where patients awake with symptoms after having no treatment overnight. The initial morning dose to offset that tends to take 30-120 minutes to kick in, which makes it the most difficult episode to treat, he says.

Other episodes that can prove problematic are when treatment wears off, and the unpredictable OFF fluctuations that can occur at any time during the day or dose cycle. Giovinazzo believes this is particularly important to note because Parkinson’s patients will eventually suffer from all of them, and their effects can be residual, leading to anxiety, depression, and a sense of loss of control.

Future efforts

In Canada, there are no approved medications for the treatment of OFF episodes. In most of the world, the most effective treatment requires a syringe injection, usually administered by a caregiver or relative.

“Cynapsus is actively pursuing the development of new medications that will help manage OFF episodes in with a delivery system that is easy to use,”  says Giovinazzo. The development of medications that are not a burden to take and act effectively are import to the patient with Parkinson’s disease. Our efforts are focusing on making that a reality.”