Solengepras, A Novel GPR6-inhibitor, Shows Potential to Improve Sleep Disturbance in Parkinson’s Disease: Results from the ASCEND Phase Two Trial
Harini Sarva1, Aaron Ellenbogen2, Kelvin Chou3, Stuart Isaacson4, Rajesh Pahwa5, Shabbir Hussain Merchant6, Tim Sheehan7, Ulysses Diva8, Nicola Brice9, Michelle Charles9, Sagar Vaidya9, Xiao Xu9, Jordan Dubow10, Karl Kieburtz10, Robert Hauser11
1Weill Cornell Medical Center, 2Quest Research Institute, 3University of Michigan Health, Department of Neurology, 4Parkinson's Dis & Mov Dis Ctr of Boca Raton, 5University of Kansas Medical Center, 6Beth Israel Deaconess Medical Center, 7Beacon Biosignals, 8U Diva Statistical Consulting, 9Cerevance, 10Clintrex, 11Parkinson’s Disease and Movement Disorders Center, Department of Neurology, University of South Florida
Objective:
To determine the effect of solengepras on sleep and non-motor symptoms in a Phase 2 study in early Parkinson's disease.
Background:

Solengepras is an inhibitor of GPR6, a novel receptor found in DRD2-expressing striatal medium spiny neurons.  In the ventral striatum, these neurons play a key role in regulation of sleep and arousal.  Solengepras is designed to modulate the indirect pathway without directly targeting dopamine receptors.  In a Phase 2 trial of early Parkinson’s disease (PD), solengepras showed improvement over placebo on MDS-UPDRS Part I; here we report further investigation of the effects on non-motor symptoms.    

Design/Methods:

ASCEND was a randomized, double-blind, placebo-controlled study in early PD patients naïve to dopaminergic therapy (NCT06006247).  Participants received solengepras 150mg once daily or placebo for 12 weeks.  Post-hoc analysis of MDS-UPDRS Part I was conducted by domain using mixed model for repeated measures (MMRM). Sleep was additionally assessed with at-home EEG monitoring via the Beacon Waveband headband. 

Results:

Sixty-four participants were randomized; 63/64(98.4%) completed the treatment period.  The solengepras-treated group had an improvement in MDS-UPDRS Part I of -1.38 versus placebo (p=0.117).  Part I results were divided into 6 non-motor domains, of which sleep-related items showed the largest standardized improvement versus placebo (3 items Q7,8,13; LS Mean [SE] -0.79 [0.37]), followed by pain (1 item; -0.29 [0.18]), and cognition (1 item; -0.15 [0.13]).  Thirty participants (placebo=17; solengepras=13) underwent at-home sleep assessments. Numerical improvements were observed with solengepras across several important measures of sleep architecture, including increased total sleep time versus placebo (+19.3 min [31.0]).

Conclusions:

In this Phase 2 study in early PD, solengepras showed potential benefits in reducing non-motor symptoms, particularly in sleep-related disturbances.  At-home sleep monitoring demonstrated no overall worsening of sleep architecture and suggested a potential benefit on sleep quality. These findings support further investigation of solengepras in addressing sleep disturbance in PD.

10.1212/WNL.0000000000213107
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