The DOI matches its Crossref record; 37 of the 38 references it cites were found in a registry or an index.
Exenatide once weekly versus placebo in Parkinson's disease: a randomised, double-blind, placebo-controlled trial
Open accessAbstract
Background Exenatide, a glucagon-like peptide-1 (GLP-1) receptor agonist, has neuroprotective effects in preclinical models of Parkinson's disease. We investigated whether these effects would be apparent in a clinical trial.Methods In this single-centre, randomised, double-blind, placebo-controlled trial, patients with moderate Parkinson's disease were randomly assigned (1:1) to receive subcutaneous injections of exenatide 2 mg or placebo once weekly for 48 weeks in addition to their regular medication, followed by a 12-week washout period. Eligible patients were aged 25-75 years, had idiopathic Parkinson's disease as measured by Queen Square Brain Bank criteria, were on dopaminergic treatment with wearing-off effects, and were at Hoehn and Yahr stage 2·5 or less when on treatment. Randomisation was by web-based randomisation with a two strata block design according to disease severity. Patients and investigators were masked to treatment allocation. The primary outcome was the adjusted difference in the Movement Disorders Society Unified Parkinson's Disease Rating Scale (MDS-UPDRS) motor subscale (part 3) in the practically defined off-medication state at 60 weeks. All efficacy analyses were based on a modified intention-to-treat principle, which included all patients who completed any post-randomisation follow-up assessments. The study is registered at ClinicalTrials.gov (NCT01971242) and is completed.Findings Between June 18, 2014, and March 13, 2015, 62 patients were enrolled and randomly assigned, 32 to exenatide and 30 to placebo. Our primary analysis included 31 patients in the exenatide group and 29 patients in the placebo group. At 60 weeks, off-medication scores on part 3 of the MDS-UPDRS had improved by 1·0 points (95% CI -2·6 to 0·7) in the exenatide group and worsened by 2·1 points (-0·6 to 4·8) in the placebo group, an adjusted mean difference of -3·5 points (-6·7 to -0·3; p=0·0318). Injection site reactions and gastrointestinal symptoms were common adverse events in both groups. Six serious adverse events occurred in the exenatide group and two in the placebo group, although none in either group were judged to be related to the study interventions.Interpretation Exenatide had positive effects on practically defined off-medication motor scores in Parkinson's disease, which were sustained beyond the period of exposure. Whether exenatide affects the underlying disease pathophysiology or simply induces long-lasting symptomatic effects is uncertain. Exenatide represents a major new avenue for investigation in Parkinson's disease, and effects on everyday symptoms should be examined in longer-term trials.Funding Michael J Fox Foundation for Parkinson's Research.
Overview
The claims and statistics of this paper haven’t been checked yet.
Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.
Integrity signals
Registry
Cites
Statistics
Verification
Claims the paper makes
The claims and statistics of this paper haven’t been checked yet.
Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.
Claims other papers make about this one
Each is checked against this paper’s own text: does it say what the citing paper says it does?
The source backs part of the claim, not all of it — or backs it for a different population, condition or comparison.
In the citing paper
“Three clinical trials consistently describe a slowed decline in motor function when using the short-acting GLP-1 receptor agonists exenatide and lixisenatide in people with Parkinson's disease; 102-104”
From GLP-1 receptor agonists and next-generation incretin-based medications: metabolic, cardiovascular, and renal benefits (2026) · cites this paper as [102]
Experimental — accuracy not yet measuredThe source backs part of the claim, not all of it — or backs it for a different population, condition or comparison.
In the citing paper
“Treatment with exenatide or lixisenatide for 1 year produced a modest but positive effect on Movement Disorder Society–Unified Parkinson’s Disease Rating Scale (MDS-UPDRS) part III scores in people with recently diagnosed Parkinson’s disease (15, 53).”
From Antiinflammatory actions of glucagon-like peptide-1–based therapies beyond metabolic benefits (2025) · cites this paper as [15]
Experimental — accuracy not yet measuredThe source backs part of the claim, not all of it — or backs it for a different population, condition or comparison.
In the citing paper
“This discrepancy may reflect differences in the neuroprotective mechanisms of semaglutide and tirzepatide vs earlier GLP-1RAs, such as exenatide, liraglutide, and lixisenatide, which have demonstrated favorable clinical benefits in early-stage Parkinson disease.33,50”
From Neurodegeneration and Stroke After Semaglutide and Tirzepatide in Patients With Diabetes and Obesity (2025) · cites this paper as [50]
Experimental — accuracy not yet measuredThe cited source says what the claim attributes to it.
In the citing paper
“In Parkinson's disease, phase II trials have shown that GLP-1 RAs such as exenatide and lixisenatide improve motor activity compared to placebo,53,54 and liraglutide has shown improvements in non-motor symptoms, mobility, and quality of life.55”
From The expanding role of GLP-1 receptor agonists: a narrative review of current evidence and future directions (2025) · cites this paper as [53]
The cited source says what the claim attributes to it.
In the citing paper
“There is increasing evidence from animal studies and clinical trials to suggest that GLP-1 receptor agonists could be beneficial in the treatment of PD, and one study using a prebiotic supplement that enhanced SCFA levels showed an increase GLP-1 levels in mouse models [141–144].”
From The gut–brain axis in early Parkinson’s disease: from prodrome to prevention (2025) · cites this paper as [142]
The check wasn’t confident either way, so it gives no verdict — never disputed.
In the citing paper
“Multiple GLP-1 medicines, including exenatide (15), liraglutide (16), semaglutide (17, 18), and tirzepatide (19), reduce plasma CRP levels in people living with T2D and/or obesity.”
From Antiinflammatory actions of glucagon-like peptide-1–based therapies beyond metabolic benefits (2025) · cites this paper as [15]
Experimental — accuracy not yet measuredThe check wasn’t confident either way, so it gives no verdict — never disputed.
In the citing paper
“Moreover, GLP-1 receptors interact with various neurotransmitter systems such as serotonin, dopamine, and glutamate, which are essential for mood regulation and may contribute to the onset of depression and other psychological disorders [82].”
From Exploring the Side Effects of GLP-1 Receptor Agonist: To Ensure Its Optimal Positioning (2025) · cites this paper as [82]
Experimental — accuracy not yet measuredThe check wasn’t confident either way, so it gives no verdict — never disputed.
In the citing paper
“There is increasing evidence from animal studies and clinical trials to suggest that GLP-1 receptor agonists could be beneficial in the treatment of PD, and one study using a prebiotic supplement that enhanced SCFA levels showed an increase GLP-1 levels in mouse models [141–144].”
From The gut–brain axis in early Parkinson’s disease: from prodrome to prevention (2025) · cites this paper as [142]
Experimental — accuracy not yet measuredIn the citing paper
“exenatide, administered at the dose approved for type 2 diabetes treatment, crosses the BBB in appreciable quantities and improves the motor and cognitive function of PD patients.”
From Microbiota–gut–brain axis and its therapeutic applications in neurodegenerative diseases (2024) · cites this paper as [616]
In the citing paper
“This study provides in vivo evidence that “beta-cell rest” can at least temporarily allow insulin secretory capacity recovery, and in vitro studies examining the effect of diazoxide on diabetic human islets produced similar findings.177”
From A review of current trends with type 2 diabetes epidemiology, aetiology, pathogenesis, treatments and future perspectives (2021) · cites this paper as [176]
Self-check
Percentages, sums and reported differences re-computed from the paper’s own numbers.
The self-check needs the paper’s full text.
Citations
Cites
1 retracted
Rampersaud, N., Harkavyi, A., Giordano, G., Lever, R., Whitton, J., & Whitton, P. S. (2012) · Neuropeptides · doi:10.1016/j.npep.2012.07.004 · Cited by 32
RetractedHughes, A. J., Daniel, S. E., Kilford, L., & Lees, A. J. (1992) · Journal of Neurology, Neurosurgery & Psychiatry · doi:10.1136/jnnp.55.3.181 · Cited by 10,378
Self-citationSystematic review of levodopa dose equivalency reporting in Parkinson's disease
Tomlinson, C. L., Stowe, R. L., Patel, S., Rick, C., Gray, R. G., & Clarke, C. E. (2010) · Movement Disorders · doi:10.1002/mds.23429 · Cited by 4,219
Buse, J. B., Rosenstock, J., Sesti, G., Schmidt, W. E., Montanya, E., Brett, J. H., Zychma, M., & Blonde, L. (2009) · The Lancet · doi:10.1016/s0140-6736(09)60659-0 · Cited by 1,503
Eng, J., Kleinman, W. A., Singh, L., Singh, G., & Raufman, J. P. (1992) · Journal of Biological Chemistry · doi:10.1016/s0021-9258(18)42531-8 · Cited by 1,000
Pancreatitis, pancreatic, and thyroid cancer with glucagon-like peptide-1-based therapies
Elashoff, M., Matveyenko, A. V., Gier, B., Elashoff, R., & Butler, P. C. (2011) · Gastroenterology · doi:10.1053/j.gastro.2011.02.018 · Cited by 944
A Double-Blind, Delayed-Start Trial of Rasagiline in Parkinson's Disease
Olanow, C. W., Rascol, O., Hauser, R. A., Feigin, P. D., Jankovic, J. J., Lang, A. E., Langston, J. W., Melamed, E., Poewe, W. H., Stocchi, F., et al. (2009) · New England Journal of Medicine · doi:10.1056/nejmoa0809335 · Cited by 902
Microglial activation and dopamine terminal loss in early Parkinson's disease
Ouchi, Y., Yoshikawa, E., Sekine, Y., Futatsubashi, M., Kanno, T., Ogusu, T., & Torizuka, T. (2005) · Annals of Neurology · doi:10.1002/ana.20338 · Cited by 864
Slower progression of Parkinson's disease with ropinirole versus levodopa: The REAL‐PET study
Whone, A. L., Watts, R. L., Stoessl, A. J., Davis, M. R., Reske, S. N., Nahmias, C., Lang, A. E., Rascol, O., Ribeiro, M. J., Rémy, P., et al. (2003) · Annals of Neurology · doi:10.1002/ana.10609 · Cited by 831
Incretin-based therapies for type 2 diabetes mellitus
Lovshin, J. A., & Drucker, D. J. (2009) · Nature Reviews Endocrinology · doi:10.1038/nrendo.2009.48 · Cited by 645
Cited by
Sorted by citations
Bloem, B. R., Okun, M. S., & Klein, C. (2021) · The Lancet · doi:10.1016/s0140-6736(21)00218-x · Cited by 3,920
Mechanisms of Action and Therapeutic Application of Glucagon-like Peptide-1
Drucker, D. J. (2018) · Cell Metabolism · doi:10.1016/j.cmet.2018.03.001 · Cited by 2,170
Glucagon-like peptide 1 (GLP-1)
Müller, T. D., Finan, B., Bloom, S. R., D'Alessio, D., Drucker, D. J., Flatt, P. R., Fritsche, A., Gribble, F., Grill, H. J., Habener, J. F., et al. (2019) · Molecular Metabolism · doi:10.1016/j.molmet.2019.09.010 · Cited by 1,868
GLP-1 receptor agonists in the treatment of type 2 diabetes - state-of-the-art
Nauck, M. A., Quast, D. R., Wefers, J., & Meier, J. J. (2021) · Molecular Metabolism · doi:10.1016/j.molmet.2020.101102 · Cited by 1,647
“In clinical trials, exenatide improved the MDS-UPDRS score (a standardized assessment scale for patients with Parkinson’s disease) [230,231].”
BackgroundBalestrino, R., & Schapira, A. H. V. (2020) · European Journal of Neurology · doi:10.1111/ene.14108 · Cited by 1,508
“Further research is needed to clarify whether the result is due to a symptomatic or disease-modifying effect [111].”
BackgroundInflammation and immune dysfunction in Parkinson disease
Tansey, M. G., Wallings, R. L., Houser, M. C., Herrick, M. K., Keating, C. E., & Joers, V. (2022) · Nature Reviews Immunology · doi:10.1038/s41577-022-00684-6 · Cited by 1,382
Hallmarks of Brain Aging: Adaptive and Pathological Modification by Metabolic States
Mattson, M. P., & Arumugam, T. V. (2018) · Cell Metabolism · doi:10.1016/j.cmet.2018.05.011 · Cited by 1,242
“A recent clinical trial revealed a therapeutic benefit of the GLP-1 analog exanatide in PD patients (Athauda et al., 2017).”
BackgroundBlock of A1 astrocyte conversion by microglia is neuroprotective in models of Parkinson’s disease
Yun, S. P., Kam, T.-I., Panicker, N., Kim, S., Oh, Y., Park, J.-S., Kwon, S.-H., Park, Y. J., Karuppagounder, S. S., Park, H., et al. (2018) · Nature Medicine · doi:10.1038/s41591-018-0051-5 · Cited by 1,123
“Importantly, the GLP-1R agonist, Exendin-4 may have a disease modifying effect in PD 4,13 .”
Microbiota–gut–brain axis and its therapeutic applications in neurodegenerative diseases
Loh, J. S., Mak, W. Q., Tan, L. K. S., Ng, C. X., Chan, H. H., Yeow, S. H., Foo, J. B., Ong, Y. S., How, C. W., & Khaw, K. Y. (2024) · Signal Transduction and Targeted Therapy · doi:10.1038/s41392-024-01743-1 · Cited by 1,193
COVID-19 and diabetes mellitus: from pathophysiology to clinical management
Lim, S. K., Bae, J. H., Kwon, H., & Nauck, M. A. (2020) · Nature Reviews Endocrinology · doi:10.1038/s41574-020-00435-4 · Cited by 1,061
The Discovery and Development of Liraglutide and Semaglutide
Knudsen, L. B., & Lau, J. (2019) · Frontiers in Endocrinology · doi:10.3389/fendo.2019.00155 · Cited by 970
Glucagon-like peptide 1 in health and disease
Andersen, A., Lund, A., Knop, F. K., & Vilsbøll, T. (2018) · Nature Reviews Endocrinology · doi:10.1038/s41574-018-0016-2 · Cited by 543
Type 2 diabetes and cognitive dysfunction–towards effective management of both comorbidities
Srikanth, V., Sinclair, A. J., Hill-Briggs, F., Moran, C., & Biessels, G. J. (2020) · The Lancet Diabetes & Endocrinology · doi:10.1016/s2213-8587(20)30118-2 · Cited by 465
GLP-1 Receptor Agonists: Beyond Their Pancreatic Effects
Zhao, X., Wang, M., Wen, Z., Lu, Z., Cui, L., Fu, C., Xue, H., Liu, Y., & Zhang, Y. (2021) · Frontiers in Endocrinology · doi:10.3389/fendo.2021.721135 · Cited by 463
“5 points in the mds-updrs exercise scale over the placebo group (74).”
BackgroundLRRK2 in Parkinson disease: challenges of clinical trials
TOLOSA, E. S., Vila, M., Klein, C., & Rascol, O. (2020) · Nature Reviews Neurology · doi:10.1038/s41582-019-0301-2 · Cited by 443
Reed, J., Bain, S., & Kanamarlapudi, V. (2021) · Diabetes, Metabolic Syndrome and Obesity: Targets and Therapy · doi:10.2147/dmso.s319895 · Cited by 441
Progress towards therapies for disease modification in Parkinson's disease
Vijiaratnam, N., Simuni, T., Bandmann, O., Morris, H. R., & Foltynie, T. (2021) · The Lancet Neurology · doi:10.1016/s1474-4422(21)00061-2 · Cited by 447
Self-citationDiscovery, characterization, and clinical development of the glucagon-like peptides
Drucker, D. J., Habener, J. F., & Holst, J. J. (2017) · Journal of Clinical Investigation · doi:10.1172/jci97233 · Cited by 418
Mitochondrial dysfunction in Parkinson’s disease – a key disease hallmark with therapeutic potential
Henrich, M. T., Oertel, W. H., Surmeier, D. J., & Geibl, F. F. (2023) · Molecular Neurodegeneration · doi:10.1186/s13024-023-00676-7 · Cited by 450
“In a randomized double-blind placebo-controlled trial on PD patients under symptomatic dopamine replacement therapy, 48 weeks of exenatide, slightly although significantly, improved motor symptoms [260].”
On Cell Loss and Selective Vulnerability of Neuronal Populations in Parkinson's Disease
Giguère, N., Burke, S., & Trudeau, L. (2018) · Frontiers in Neurology · doi:10.3389/fneur.2018.00455 · Cited by 432
Efficacy and Safety of GLP-1 Medicines for Type 2 Diabetes and Obesity
Drucker, D. J. (2024) · Diabetes Care · doi:10.2337/dci24-0003 · Cited by 383
Lang, A. E., & Espay, A. J. (2018) · Movement Disorders · doi:10.1002/mds.27360 · Cited by 383
New insights into the complex role of mitochondria in Parkinson’s disease
Grünewald, A., Kumar, K. R., & Sue, C. M. (2018) · Progress in Neurobiology · doi:10.1016/j.pneurobio.2018.09.003 · Cited by 375
Trial of Lixisenatide in Early Parkinson’s Disease
Meissner, W. G., Remy, P., Giordana, C., Maltête, D., Derkinderen, P., Houéto, J.-L., Anheim, M., Benatru, I., Boraud, T., Brefel-Courbon, C., et al. (2024) · New England Journal of Medicine · doi:10.1056/nejmoa2312323 · Cited by 369
Anti-inflammatory role of glucagon-like peptide 1 receptor agonists and its clinical implications
Alharbi, S. H. (2024) · Therapeutic Advances in Endocrinology and Metabolism · doi:10.1177/20420188231222367 · Cited by 358
Pleiotropic Effects of GLP-1 and Analogs on Cell Signaling, Metabolism, and Function
Rowlands, J., Heng, J., Newsholme, P., & Carlessi, R. (2018) · Frontiers in Endocrinology · doi:10.3389/fendo.2018.00672 · Cited by 302
“This is in contrast to the UK based studies (NCT01971242 and NCT01971242) which noted a positive and persistent effect of Exenatide treatment in off-medication motor scores (267).”
BackgroundResultThe Therapeutic Potential of Metformin in Neurodegenerative Diseases
Rotermund, C., Machetanz, G., & Fitzgerald, J. C. (2018) · Frontiers in Endocrinology · doi:10.3389/fendo.2018.00400 · Cited by 316
“Very recently a randomized, double-blind, placebo-controlled trial for PD showed that a GLP-1 agonist had positive effects on motor symptoms in PD (237), generating a new potential mechanism for metformin action in neurodegeneration.”
BackgroundEmerging therapies in Parkinson disease — repurposed drugs and new approaches
Elkouzi, A., Vedam‐Mai, V., Eisinger, R. S., & Okun, M. S. (2019) · Nature Reviews Neurology · doi:10.1038/s41582-019-0155-7 · Cited by 315
α-Synuclein pathology in Parkinson’s disease and related α-synucleinopathies
Henderson, M. X., Trojanowski, J. Q., & Lee, V. M. ‐. (2019) · Neuroscience Letters · doi:10.1016/j.neulet.2019.134316 · Cited by 301
Kopp, K. O., Glotfelty, E. J., Li, Y., & Greig, N. H. (2022) · Pharmacological Research · doi:10.1016/j.phrs.2022.106550 · Cited by 298
Self-citationTherapeutic strategies for Parkinson disease: beyond dopaminergic drugs
Charvin, D., Medori, R., Hauser, R. A., & Rascol, O. (2018) · Nature Reviews Drug Discovery · doi:10.1038/nrd.2018.136 · Cited by 294
Klausen, M. K., Jensen, M. E., Møller, M., Le Dous, N., Jensen, A.-M. Ø., Zeeman, V. A., Johannsen, C.-F., Lee, A., Thomsen, G. K., Macoveanu, J., et al. (2022) · JCI Insight · doi:10.1172/jci.insight.159863 · Cited by 262
“Importantly, exenatide crosses the bloodbrain barrier (20), and a similar dosing regimen, i.”
The Impact of Disease Comorbidities in Alzheimer’s Disease
Santiago, J. A., & Potashkin, J. A. (2021) · Frontiers in Aging Neuroscience · doi:10.3389/fnagi.2021.631770 · Cited by 259
“Exendin-4 (exenatide), a GLP-1 receptor agonist, has been shown to improve motor symptoms in PD clinical trials (Aviles-Olmos et al., 2013; Athauda et al., 2017).”
BackgroundThe role of glucagon‐like peptide 1 (GLP‐1) in addictive disorders
Klausen, M. K., Thomsen, M., Wortwein, G., & Fink‐Jensen, A. (2022) · British Journal of Pharmacology · doi:10.1111/bph.15677 · Cited by 259
“with Parkinson's disease, where an effect on off-medication motor scores was reported, but no significant effect on DAT availability after 48 weeks of treatment (Athauda et al., 2017).”
BackgroundAthauda, D. S., Gulyani, S., Karnati, H. K., Li, Y., Tweedie, D., Mustapić, M., Chawla, S., Chowdhury, K., Skene, S. S., Greig, N. H., et al. (2019) · JAMA Neurology · doi:10.1001/jamaneurol.2018.4304 · Cited by 259
“Patients and Study Design TheExenatide-PD trial (a randomized, double-blind, placebocontrolled, single center, 60-week trial of exenatide once weekly for the treatment of moderate-severity PD(43)) (NCT01971242)wasperformed fromJune 18, 2014, to June 16, 2016, to assess the effects of exenatide ondiseaseprogression for…”
BackgroundResultSelf-citationHuman trials exploring anti-aging medicines
Guarente, L., Sinclair, D. A., & Kroemer, G. (2024) · Cell Metabolism · doi:10.1016/j.cmet.2023.12.007 · Cited by 266
Medical, surgical, and physical treatments for Parkinson's disease.
Foltynie, T., Bruno, V., Fox, S. H., Kühn, A., Lindop, F., & Lees, A. (2024) · The Lancet · doi:10.1016/s0140-6736(23)01429-0 · Cited by 197
Self-citationReich, N., & Hölscher, C. (2022) · Frontiers in Neuroscience · doi:10.3389/fnins.2022.970925 · Cited by 248
Hou, Y.-F., Shan, C., Zhuang, S.-Y., Zhuang, Q.-Q., Ghosh, A., Zhu, K.-C., Kong, X.-K., Wang, S.-M., Gong, Y.-L., Yang, Y.-Y., et al. (2021) · Microbiome · doi:10.1186/s40168-020-00988-6 · Cited by 231
Batista, A. F., Forny‐Germano, L., Clarke, J. R., Silva, N. M. L. E., Brito‐Moreira, J., Boehnke, S. E., Winterborn, A., Coe, B. C., Lablans, A., Vital, J. F. S., et al. (2018) · The Journal of Pathology · doi:10.1002/path.5056 · Cited by 251
GLP-1-based therapies for diabetes, obesity and beyond
Drucker, D. J. (2025) · Nature Reviews Drug Discovery · doi:10.1038/s41573-025-01183-8 · Cited by 297
“Positive results, principally the halting of disease progression, were reported in trials of exenatide twice daily 136 , exenatide once weekly 137 and lixisenatide once daily 138 .”
Beyond the pancreas: contrasting cardiometabolic actions of GIP and GLP1
Hammoud, R., & Drucker, D. J. (2023) · Nature Reviews Endocrinology · doi:10.1038/s41574-022-00783-3 · Cited by 244
“…small, randomized trials examined the effects of twice daily or once weekly exenatide versus conventional therapy for 12 months in people with moderate Parkinson disease without T2DM and demonstrated improved motor activity scores that persisted following discontinuation of exenatide 160,161 .”
The expanding incretin universe: from basic biology to clinical translation
Drucker, D. J., & Holst, J. J. (2023) · Diabetologia · doi:10.1007/s00125-023-05906-7 · Cited by 243
Diabetes mellitus and Parkinson disease
Pagano, G., Polychronis, S., Wilson, H., Giordano, B., Ferrara, N., Niccolini, F., & Politis, M. (2018) · Neurology · doi:10.1212/wnl.0000000000005475 · Cited by 243
“Most of our patients were only treated with dietary changes or metformin monotherapy, and we were unable to perform a comparison with the new antidiabetic drugs, such as the GLP-1 analog exenatide, which exerted beneficial effects on patients with PD in a 12-month, randomized, double-blind, placebo-controlled trial.(3…”
BackgroundResultAssociation between diabetes and subsequent Parkinson disease: A record-linkage cohort study
De Pablo-Fernandez, E., Goldacre, R., Pakpoor, J., Noyce, A. J., & Warner, T. T. (2018) · Neurology · doi:10.1212/wnl.0000000000005771 · Cited by 242
“A recent doubleblind trial involving 62 patients with PD randomly assigned to placebo or exenatide 2-mg weekly injections showed positive and persistent effects on motor symptoms measured by section 3 of the Movement Disorder Society–Unified Parkinson’s Disease Rating Scale.(9)Whether the effect is secondary to sympto…”
BackgroundSelf-citationType 2 Diabetes as a Determinant of Parkinson's Disease Risk and Progression
Chohan, H., Senkevich, K., Patel, R. K., Bestwick, J. P., Jacobs, B. M., Bandres Ciga, S., Gan‐Or, Z., & Noyce, A. J. (2021) · Movement Disorders · doi:10.1002/mds.28551 · Cited by 228
“A double-blind, placebocontrolled trial showed that the GLP-1 analogue, Exenatide, may have an effect on reducing PD severity after a prolonged washout period, increasing the possibility of a disease-modifying effect.(64) A recent cohort study from the same group reported evidence that patients with T2DM taking certai…”
BackgroundDiabetes medications and risk of Parkinson’s disease: a cohort study of patients with diabetes
Brauer, R., Wei, L., Ma, T., Athauda, D., Girges, C., Vijiaratnam, N., Auld, G., Whittlesea, C., Wong, I., & Foltynie, T. (2020) · Brain · doi:10.1093/brain/awaa262 · Cited by 233
“The positive markers from this population study seem to be further supported by the findings of potential disease modifying effects of two single centre phase 2 interventional studies (Aviles-Olmos et al., 2014; Athauda et al., 2017).”
BackgroundResultSelf-citationThe Association Between Type 2 Diabetes Mellitus and Parkinson’s Disease
Cheong, J. L. Y., Pablo‐Fernández, E. D., Foltynie, T., & Noyce, A. J. (2020) · Journal of Parkinson s Disease · doi:10.3233/jpd-191900 · Cited by 236
“5 points less on the MDS-UPDRS than those not treated with exenatide, following a washout period to exclude a symptomatic effect [105].”
BackgroundSelf-citationGlucagon-Like Peptide-1: A Focus on Neurodegenerative Diseases
Grieco, M., Giorgi, A., Gentile, M. C., d’Erme, M., Morano, S., Maras, B., & Filardi, T. (2019) · Frontiers in Neuroscience · doi:10.3389/fnins.2019.01112 · Cited by 218
Parkinson disease therapy: current strategies and future research priorities
Stocchi, F., Bravi, D., Emmi, A., & Antonini, A. (2024) · Nature Reviews Neurology · doi:10.1038/s41582-024-01034-x · Cited by 247
“For example, glucagon-like peptide 1 receptor agonists that are used to treat diabetes have shown promise in patients with PD, highlighting a potential role for brain insulin signalling and insulin receptors in this condition 133,134 .”
Initiation of pharmacological therapy in Parkinson's disease: when, why, and how
de Bie, R. M. A., Clarke, C. E., Espay, A. J., Fox, S. H., & Lang, A. E. (2020) · The Lancet Neurology · doi:10.1016/s1474-4422(20)30036-3 · Cited by 200
Glucose metabolic crosstalk and regulation in brain function and diseases
Zhang, S., Lachance, B. B., Mattson, M. P., & Jia, X. (2021) · Progress in Neurobiology · doi:10.1016/j.pneurobio.2021.102089 · Cited by 213
Hölscher, C. (2018) · Neuropharmacology · doi:10.1016/j.neuropharm.2018.01.040 · Cited by 203
“Importantly, GLP-1 mimetics can cross the BBB (Athauda et al., 2017; Christensen et al., 2015; Hunter and Holscher, 2012; Kastin and Akerstrom, 2003; Kastin et al., 2002; McClean et al., 2011b).”
BackgroundInfluentialKia, D. A., Zhang, D., Guelfi, S., Manzoni, C., Hubbard, L., Reynolds, R. H., Botía, J. A., Ryten, M., Ferrari, R., Lewis, P. A., et al. (2021) · JAMA Neurology · doi:10.1001/jamaneurol.2020.5257 · Cited by 206
“This finding issupportedbyrecentwork indicating an association between bodymass index and PD, and a randomized clinical trial of exenatide, a glucagon-like peptide 1 receptor agonist, as adisease-modifyingagent forPD.(30,31) Furthermore, a role forCD38 in regulatingneuroinflammation, especially in glial cells, has bee…”
ResultSelf-citationSalameh, T. S., Rhea, E. M., Talbot, K., & Banks, W. A. (2020) · Biochemical Pharmacology · doi:10.1016/j.bcp.2020.114187 · Cited by 188
“The single IRAs thus far demonstrating the greatest promise as AD and/or PD therapeutics are the FDA approved GLP-1 receptor agonists (GLP-1RAs) exendin-4 (Byetta®) [42, 43, 56-58, 65-67, 84], liraglutide (Victoza®) [36-41, 43, 48-50, 53, 85], lixisenatide (Adlyxin® in the U.”
BackgroundThe Antidepressant Effects of GLP-1 Receptor Agonists: A Systematic Review and Meta-Analysis
Chen, X., Zhao, P., Wang, W., Guo, L., & Pan, Q. (2024) · The American Journal of Geriatric Psychiatry · doi:10.1016/j.jagp.2023.08.010 · Cited by 185
Sorrentino, Z. A., Giasson, B. I., & Chakrabarty, P. (2019) · Acta Neuropathologica · doi:10.1007/s00401-019-01977-2 · Cited by 179
“1 3 double-blind trial of the GLP1R agonist exenatide appeared to improve motor and cognitive function in PD patients [10, 11].”
Antidiabetic agents as a novel treatment for Alzheimer’s and Parkinson’s disease
Nowell, J., Blunt, E., Gupta, D., & Edison, P. (2023) · Ageing Research Reviews · doi:10.1016/j.arr.2023.101979 · Cited by 179
“In two meta-analyses (Mulvaney et al., 2020; Wang et al., 2020b) of GLP-1 receptor agonists, only the two previously discussed trials met the inclusion criteria (Athauda et al., 2017; Aviles-Olmos et al., 2013).”
Brain insulin resistance: role in neurodegenerative disease and potential for targeting
Hölscher, C. (2020) · Expert Opinion on Investigational Drugs · doi:10.1080/13543784.2020.1738383 · Cited by 180
“Growth factors such as insulin, GLP-1 and GIP can cross the BBB and offer a promising treatment strategy [87, 91, 92, 197].”
BackgroundCopas, A. N. M., McComish, S. F., Fletcher, J. M., & Caldwell, M. A. (2021) · Frontiers in Neurology · doi:10.3389/fneur.2021.666737 · Cited by 183
Timper, K., del Río-Martín, A., Cremer, A. L., Bremser, S., Alber, J., Giavalisco, P., Varela, L., Heilinger, C., Nolte, H., Trifunovic, A., et al. (2020) · Cell Metabolism · doi:10.1016/j.cmet.2020.05.001 · Cited by 170
The multifaceted pyruvate metabolism: role of the mitochondrial pyruvate carrier
Zangari, J., Petrelli, F., Maillot, B., & Martinou, J.-C. (2020) · Biomolecules · doi:10.3390/biom10071068 · Cited by 172
Vijiaratnam, N., Girges, C., Auld, G., McComish, R., King, A., Skene, S. S., Hibbert, S., Wong, A., Melander, S., Gibson, R., et al. (2025) · The Lancet · doi:10.1016/s0140-6736(24)02808-3 · Cited by 181
Self-citationRecent developments in the treatment of Parkinson's Disease
Stoker, T. B., & Barker, R. A. (2020) · F1000Research · doi:10.12688/f1000research.25634.1 · Cited by 174
A Pilot Study of Exenatide Actions in Alzheimer’s Disease
Mullins, R. J., Mustapić, M., Chia, C. W., Carlson, O. D., Gulyani, S., Tran, J., Li, Y., Mattson, M. P., Resnick, S. M., Egan, J. M., et al. (2019) · Current Alzheimer Research · doi:10.2174/1567205016666190913155950 · Cited by 162
Self-citationTrapp, S., & Brierley, D. I. (2022) · British Journal of Pharmacology · doi:10.1111/bph.15638 · Cited by 154
“…GLP-1 receptor agonists seem to have beneficial effects on other organs including the brain, with potential neuroprotective effects, even in Alzheimer's and in Parkinson's disease (Athauda et al., 2017; During et al., 2003; Foltynie & Athauda, 2020; Gault & Holscher, 2008; McClean et al., 2011).”
BackgroundZhang, L., Zhang, L., Li, L., & Hölscher, C. (2019) · Journal of Parkinson's Disease · doi:10.3233/jpd-181503 · Cited by 173
“Importantly, a phase II clinical trial showed protective effects in PD patients even 3 months after treatment had been discontinued [24].”
Zhang, L., Zhang, L., Li, L., & Hölscher, C. (2018) · Neuropeptides · doi:10.1016/j.npep.2018.07.003 · Cited by 151
McGarry, A., Rosanbalm, S., Leinonen, M., Olanow, C. W., To, D., Bell, A., Lee, D., Chang, J., Dubow, J., Dhall, R., et al. (2024) · The Lancet Neurology · doi:10.1016/s1474-4422(23)00378-2 · Cited by 153
Diet in Parkinson’s Disease: Critical Role for the Microbiome
Jackson, A., Forsyth, C. B., Shaikh, M., Voigt, R. M., Engen, P. A., Ramirez, V., & Keshavarzian, A. (2019) · Frontiers in Neurology · doi:10.3389/fneur.2019.01245 · Cited by 145
Protective properties of GLP‐1 and associated peptide hormones in neurodegenerative disorders
Hölscher, C. (2021) · British Journal of Pharmacology · doi:10.1111/bph.15508 · Cited by 149
“Unfortunately, there are few studies that measure levels of such drugs in the CSF in humans to estimate the BBB penetrations.”
BackgroundMethodInfluentialManagement of hypoglycemia in older adults with type 2 diabetes
Freeman, J. S. (2019) · Postgraduate Medicine · doi:10.1080/00325481.2019.1578590 · Cited by 153
“Improvements in motor and cognitive assessments have been demonstrated in a clinical trial of exenatide in patients with Parkinson’s disease [70], and other trials assessing exenatide and liraglutide in both disease states are currently ongoing.”
BackgroundMoiz, A., Filion, K. B., Tsoukas, M. A., Yu, O. H. Y., Peters, T. M., & Eisenberg, M. J. (2025) · EClinicalMedicine · doi:10.1016/j.eclinm.2025.103363 · Cited by 157
“In Parkinson’s disease, phase II trials have shown that GLP-1 RAs such as exenatide and lixisenatide improve motor activity compared to placebo, 53,54 and liraglutide has shown improvements in non-motor symptoms, mobility, and quality of life.”
Parkinson’s Disease Drug Therapies in the Clinical Trial Pipeline: 2020
McFarthing, K., Buff, S., Rafaloff, G., Dominey, T., Wyse, R. K. H., & Stott, S. (2020) · Journal of Parkinson s Disease · doi:10.3233/jpd-202128 · Cited by 138
Kim, D. S., Choi, H.-I., Wang, Y., Luo, Y., Hoffer, B. J., & Greig, N. H. (2017) · Cell Transplantation · doi:10.1177/0963689717721234 · Cited by 136
“”(99) This suggests disease-modifying effects of exenatide, and the results are encouraging enough that a subsequent doubleblind clinical study (NCT01971242) was initiated by the same investigators using a sustained release formulation of exenatide (Bydureon: 2 mg administered subcutaneously once weekly) to evaluate i…”
BackgroundMethodResultInfluentialSelf-citationHong, C.-T., Chen, K.-Y., Wang, W., Chiu, J.-Y., Wu, D., Chao, T.-Y., Hu, C.-J., Chau, K.-Y., & Bamodu, O. (2020) · Cells · doi:10.3390/cells9030740 · Cited by 133
“Furthermore, several anti-glycemic agents, including exenatide, a glucagon-like peptide analogue, have exerted a disease-modifying effect on PD; exenatide is presently in phase III clinical trial as a neuroprotective drug for patients with PD [18,19].”
BackgroundWong, C. K., Yusta, B., Koehler, J. A., Baggio, L. L., McLean, B. A., Matthews, D., Seeley, R. J., & Drucker, D. J. (2022) · Cell Metabolism · doi:10.1016/j.cmet.2022.08.003 · Cited by 138
Incretin and insulin signaling as novel therapeutic targets for Alzheimer’s and Parkinson’s disease
Nowell, J., Blunt, E., & Edison, P. (2023) · Molecular Psychiatry · doi:10.1038/s41380-022-01792-4 · Cited by 136
“Exenatide was also safe and well-tolerated, with no patients in the exenatide-treated group withdrawn due to excessive weight loss and weight loss reversed following drug cessation, within the latest trial [87].”
BackgroundInfluentialTargeting Mitochondrial Impairment in Parkinson's Disease: Challenges and Opportunities
Prasuhn, J., Davis, R. L., & Kumar, K. R. (2021) · Frontiers in Cell and Developmental Biology · doi:10.3389/fcell.2020.615461 · Cited by 135
“Moreover, the drug exenatide has been shown to improve motor scores in PD and may have beneficial effects on mitochondrial biogenesis (Fan et al., 2010; Athauda et al., 2017).”
BackgroundTai, J., Liu, W., Li, Y., Li, L., & Hölscher, C. (2017) · Brain Research · doi:10.1016/j.brainres.2017.10.012 · Cited by 135
“In contrast, the placebo group deteriorated over time as would be expected in this disease (Athauda et al., 2017).”
Self-citationConnecting Alzheimer's disease to diabetes: Underlying mechanisms and potential therapeutic targets
Vieira, M. N. N., Lima‐Filho, R. A. S., & Felice, F. G. D. (2017) · Neuropharmacology · doi:10.1016/j.neuropharm.2017.11.014 · Cited by 133
“Clinical trials aimed at testing the efficacy of insulin and GLP-1 analogues in Alzheimer's and Parkinson's disease and in mood disorders have shown some beneficial effects (Athauda et al., 2017; Claxton et al., 2015; Craft et al., 2012; Gejl et al., 2016; Mansur et al., 2017; Reger et al., 2008).”
The heterogeneity of Parkinson’s disease
Wüllner, U., Borghammer, P., Choe, C., Csóti, I., Falkenburger, B. H., Gasser, T., Lingor, P., & Riederer, P. F. (2023) · Journal of Neural Transmission · doi:10.1007/s00702-023-02635-4 · Cited by 144
“Among approved GLP-1 agonists, exenatide has emerged as a promising disease-modifying drug in PD (Athauda et al. 2017).”
Emerging Treatment Approaches for Parkinson’s Disease
Stoker, T. B., Torsney, K., & Barker, R. A. (2018) · Frontiers in Neuroscience · doi:10.3389/fnins.2018.00693 · Cited by 135
GLP-1’s role in neuroprotection: a systematic review
Erbil, D., Eren, C. Y., Demirel, Ç., Küçüker, M. U., Solaroğlu, İ., & Eser, H. Y. (2019) · Brain Injury · doi:10.1080/02699052.2019.1587000 · Cited by 129
Zhao, L., Li, Z., Vong, J. S. L., Chen, X., Lai, H. M., Yan, L. Y. C., Huang, J., Sy, S. K. H., Tian, X. Y., Huang, Y., et al. (2020) · Nature Communications · doi:10.1038/s41467-020-18249-3 · Cited by 125
Parkinson’s disease determinants, prediction and gene–environment interactions in the UK Biobank
Jacobs, B. M., Belete, D., Bestwick, J. P., Blauwendraat, C., Bandrés‐Ciga, S., Heilbron, K., Dobson, R., Nalls, M. A., Singleton, A., Hardy, J., et al. (2020) · Journal of Neurology Neurosurgery & Psychiatry · doi:10.1136/jnnp-2020-323646 · Cited by 126
Self-citationInsulin Signaling Impairment in the Brain as a Risk Factor in Alzheimer’s Disease
Hölscher, C. (2019) · Frontiers in Aging Neuroscience · doi:10.3389/fnagi.2019.00088 · Cited by 122
“In a doubleblind, placebo-controlled phase II clinical trial in PD patients, the GLP-1 receptor agonist exendin-4 showed good protective effects compared to placebo, even after 3 months of wash-out of the drug (Athauda et al., 2017).”
BackgroundUnderstanding the Links Between Cardiovascular Disease and Parkinson's Disease
Potashkin, J., Huang, X., Becker, C., Chen, H., Foltynie, T., & Marras, C. (2019) · Movement Disorders · doi:10.1002/mds.27836 · Cited by 121
“In a 1-year phase II trial of 60 patients randomized to self-inject exenatide or placebo, PD patients using exenatide had smaller increase in theMovement Disorders Society Unified PD Rating Scale part 3 motor scores when assessed in the off medication state.(156) Despite the washout design of this trial (the primary o…”
MethodSelf-citationFeng, P., Zhang, X., Li, D., Ji, C., Yuan, Z., Wang, R., Xue, G., Li, G., & Hölscher, C. (2018) · Neuropharmacology · doi:10.1016/j.neuropharm.2018.02.012 · Cited by 117
“CSF analysis confirmed that exendin-4 had crossed the BBB, and that there was no drug present after wash-out (Athauda et al., 2017).”
Emerging neuroprotective effect of metformin in Parkinson’s disease: A molecular crosstalk
Paudel, Y. N., Angelopoulou, E., Piperi, C., Shaikh, M. F., & Othman, I. (2019) · Pharmacological Research · doi:10.1016/j.phrs.2019.104593 · Cited by 115
Pharmacological Treatment of Parkinson’s Disease
Zahoor, I., Shafi, A., & Haq, E. (2018) · Codon Publications eBooks · doi:10.15586/codonpublications.parkinsonsdisease.2018.ch7 · Cited by 120
“Thereafter, it was taken forward to a single-center, randomized, double-blind, placebo-controlled Phase 2 clinical trial in which a weekly dosage of 2 mg was administered to patients subcutaneously (85).”
MethodRhee, S. Y., Han, K.-D., Kwon, H., Park, S.-E., Park, Y.-G., Kim, Y.-H., Yoo, S.-J., Rhee, E.-J., & Lee, W.-Y. (2020) · Diabetes Care · doi:10.2337/dc19-0760 · Cited by 109
“Recently, a double-blind, randomized, controlled study on the effects of glucagon-like peptide 1 agonists in PD subjects showed a positive effect in the intervention group (34).”
BackgroundThe Relevance of Insulin Action in the Dopaminergic System
Fiory, F., Perruolo, G., Cimmino, I., Cabaro, S., Pignalosa, F. C., Miele, C., Bèguinot, F., Formisano, P., & Oriente, F. (2019) · Frontiers in Neuroscience · doi:10.3389/fnins.2019.00868 · Cited by 118
The Non‐Motor Symptoms Scale in Parkinson’s disease: Validation and use
van Wamelen, D. J., Martínez‐Martín, P., Weintraub, D. A., Schrag, A. E., Antonini, A., Falup‐Pecurariu, C., Odin, P., Chaudhuri, К. R., & International Parkinson and Movement Disorder Society Parkinson's Disease Non‐Motor Study Group (2020) · Acta Neurologica Scandinavica · doi:10.1111/ane.13336 · Cited by 114
Song, S., Guo, R., Mehmood, A., Zhang, L., Yin, B., Yuan, C., Zhang, H., Guo, L., & Li, B. (2022) · CNS Neuroscience & Therapeutics · doi:10.1111/cns.13791 · Cited by 115
Protective role of IGF-1 and GLP-1 signaling activation in neurological dysfunctions
Bhalla, S., Mehan, S., Khan, A., & Rehman, M. U. (2022) · Neuroscience & Biobehavioral Reviews · doi:10.1016/j.neubiorev.2022.104896 · Cited by 108
Novel targeted therapies for Parkinson’s disease
Ntetsika, T., Papathoma, P.-E., & Markaki, I. (2021) · Molecular Medicine · doi:10.1186/s10020-021-00279-2 · Cited by 119
“In a phase 2 study of the GLP-1 RA exenatide for 12 months in 60 PD patients, the treatment showed efficacy in motor symptoms, and a good safety profile (Athauda et al. 2017).”
BackgroundRecent Advances in Drug Therapy for Parkinson's Disease
Murakami, H., Shiraishi, T., Umehara, T., Omoto, S., & Iguchi, Y. (2022) · Internal Medicine · doi:10.2169/internalmedicine.8940-21 · Cited by 114
“A phase 2 study of exenatide, a GLP-1 receptor agonist, showed efficacy for motor symptoms and a reduced rate of decline in nigrostriatal dopaminergic neurons using DAT imaging (40).”
GLP-1 Receptor Agonists: A New Treatment in Parkinson’s Disease
Kalinderi, K., Papaliagkas, V. T., & Fidani, L. (2024) · International Journal of Molecular Sciences · doi:10.3390/ijms25073812 · Cited by 122
“Due to these positive results, a randomized, double-blind, placebo-controlled phase II clinical study (NCT01971242) [69], was conducted by the same research team with subcutaneous administration of exendin-4, one injection/week for 48 weeks in 60 PD patients with moderate disease.”
BackgroundParkinson’s progression prediction using machine learning and serum cytokines
Rastegar, D. A., Ho, N., Halliday, G. M., & Dzamko, N. L. (2019) · npj Parkinson s Disease · doi:10.1038/s41531-019-0086-4 · Cited by 109
Metadata
- Authors
- Athauda, D., Maclagan, K., Skene, S. S., Bajwa-Joseph, M., Letchford, D., Chowdhury, K., Hibbert, S., Budnik, N., Zampedri, L., Dickson, J., Li, Y., Aviles-Olmos, I., Warner, T. T., Limousin, P., Lees, A. J., Greig, N. H., Tebbs, S., & Foltynie, T.
- Affiliations
- National Hospital for Neurology and Neurosurgery (GB)
- University College London (GB)
- National Institute on Aging (US)
- Corresponding author
- Foltynie, Thomas
- ORCID
- Venue
- The Lancet
- Publisher
- Elsevier BV
- Published
- 2017-10
- Volume
- 390
- Issue
- 10103
- Pages
- 1664-1675
- ISSN
- 0099-5355 (ISSN-L)
- 0140-6736
- PMC
- PMC5831666
- OpenAlex
- W2744843428
- Cited by
- 889
- References
- 38
- Citations by year
- 2026: 114 · 2025: 136 · 2024: 114 · 2023: 73 · 2022: 85 · 2021: 93 · 2020: 98 · 2019: 77 · 2018: 77 · 2017: 20
- FWCI
- 51.34
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- The Lancet (publishedVersion)
- PubMed (publishedVersion)
- Europe PMC (PubMed Central) (acceptedVersion)
- PubMed Central (acceptedVersion)
- Open Research (University of Surrey) (submittedVersion)
- LA Referencia (Red Federada de Repositorios Institucionales de Publicaciones Científicas) (submittedVersion, other-oa)
- UCL Discovery (University College London) (submittedVersion)
- Surrey Research Insight Open Access (The University of Surrey) (submittedVersion)
- Funders
- National Institutes of Health (Z99 AG999999)
- Topics
- Health Sciences › Medicine › Clinical Neurology › Parkinson's Disease Mechanisms and Treatments
- Health Sciences › Medicine › Clinical Neurology › Deep Brain Stimulation and Movement Disorders
- Life Sciences › Biochemistry, Genetics and Molecular Biology › Molecular Biology › Nuclear Receptors and Signaling
- Keywords
- Parkinson's disease, exenatide, GLP-1 receptor agonists, neuroprotection, motor symptoms, off-medication state, dopaminergic therapy, neurodegeneration, adverse events, injection site reactions, gastrointestinal symptoms, drug repurposing, disease-modifying therapy
- MeSH terms
- Exenatide, Adult, Aged, Double-Blind Method, Drug Administration Schedule, Female, Humans, Male, Middle Aged, Neurologic Examination, Parkinson Disease, Peptides, Venoms, Treatment Outcome
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
Are you an author, or do you see a problem with this page? Request a review