We await the results of studies on neuromodulatory therapies

Prof. Jaroslaw Slawek:

• Parkinson's disease affects 1.5 percent of the population over the age of 65. In the general population, it is 0.3 percent.
• According to the National Health Service, we have about 90,000 patients in Poland.
• Every year, Parkinson's disease is diagnosed in 5,000 people in Poland.
• The incidence curve has been rising faster than expected in recent years.
• The increasing number of sick people is, on the one hand, the result of an aging population, and on the other hand, the impact of environmental factors, pollution, dust we breathe in, pesticides.
• The stereotypical Parkinson's disease patient is an elderly person with tremors. However, the disease on average begins around age 58, and we sometimes have patients as young as 25. Tremors are also not specific to Parkinson's disease; there are more common causes, such as spontaneous tremors.
• The time from the onset of the first symptoms to diagnosis is (in the world) about 2 years, in Poland it is sometimes even longer, meanwhile, treatment should be implemented as soon as possible.
• The Polish system does not provide reference centers for patients with Parkinson's disease.
• The outpatient counseling system and the referral system of centers need to be changed. Regional reference centers are needed.
• The Ministry of Health has commissioned AOTMiT to prepare a pilot program for coordinated care for patients with Parkinson's disease. The program is expected to be ready in the fall.
• Treatment of Parkinson's disease depends on its stage. The early stage (which lasts up to 10 years) uses drugs, most of which are available in Poland, but some are still not reimbursed.
• The greatest progress has been made in the treatment of advanced disease - as of 2018, we can offer such patients infusion therapies: apomorphine, administered subcutaneously via a pump, and duodopa, administered as an enteral gel (via PEG).
• The duodopa system will evolve into subcutaneous, less invasive (PEG-free) therapies.
• Newer pumps for apomorphine administration are the size of a cell phone, and can be conveniently mounted on a belt.
• Brain stimulation techniques are being improved. New stimulators adapt automatically to the patient's motor state (the so-called closed-loop concept).
• Research on neuromodulatory biologic therapies is underway. A multicenter phase III trial involving several hundred patients, in which a monoclonal antibody is being evaluated, is also underway. The results will be known in 2025.
• Gene therapies are still in the experimental stage.
• Regular physical activity is extremely important for brain health.