March 21, 2026

@michaelokun

A new drug 'on the block' for Parkinson’s: Tavapadon, a D1/D5 selective dopamine agonist. Randomized trial results are in and positive. Randomized means participants were assigned by chance to different groups. Pahwa and colleagues describe in their new paper in JAMA Neurology the results of a phase 3 randomized trial of Tavapadon in EARLY Parkinson’s disease. Key Points: - Tavapadon significantly improved motor symptoms as measured by MDS-UPDRS II and III scores compared to placebo over 26 weeks. - Clinical benefit emerged as early as week 5 and was sustained through the duration of the study. - The drug demonstrated a favorable safety profile, w/ most adverse events mild to moderate including nausea, headache and dizziness. My take: This is an important study that brings a D1/D5 selective dopamine agonist into the spotlight. The idea of targeting D1 pathways while potentially avoiding some of the D2/D3 related side effects is compelling. However, we should be cautious as longer term data will be critical to understand durability, safety and real world impact. Here are 5 points that resonated w/ me: 1- Early Parkinson’s disease remains a window where smarter therapies could meaningfully alter trajectories. 2- Selective D1/D5 agonism represents a different pharmacologic strategy compared to traditional dopamine agonists. 3- The magnitude of motor improvement in this trial appears clinically meaningful and not just statistically significant. 4- Side effects were frequent, however mostly manageable, and this balance will matter in early disease decision making. 5- The future will hinge on long term safety, comparative effectiveness and identifying which folks benefit the most. https://cutt.ly/btIYBwr3 #parkinson #michaelokun #fixelinstitute