Could a Parkinson's drug reduce the frequency of injections for wet AMD?

Researchers at Queen's University Belfast are launching a new trial to look at whether L-DOPA, a drug currently used to treat Parkinson's disease, could help people living with wet age-related macular degeneration (AMD).

The LAMDARCT study, funded by the National Institute for Health and Care Research and sponsored by Belfast Health and Social Care Trust, is the first trial in the UK of its kind exploring whether the drug could reduce the number of Anti-VEGF injections needed by patients with the condition. 

Wet AMD currently requires regular eye injections from as often as every six weeks. The LAMDARCT trial will explore whether adding a low-dose of L-DOPA, an oral capsule taken twice daily, alongside regular anti-VEGF treatment, could reduce how many injections patients need, while maintaining their vision.

Why L-DOPA? 

The study was prompted by previous research, including preclinical studies and observational studies, where Parkinson's patients already taking L-DOPA appeared less likely to develop wet AMD, and those who did tended to require fewer injections. These findings are preliminary and have not yet been confirmed in randomised clinical trials.

At the Macular Society’s March My Macular and Me webinar, Dr Katie Curran, who is a co-investigator on the trial, said: “If this is effective, then the use of the L-DOPA could potentially transform AMD care. It would reduce the number of injections needed to treat AMD. It would potentially lower the costs for the healthcare service and also for you as patients and carers.”

Will patients be able to stop injections? 

During the trial patients will continue to be on their regular treatment. The L-DOPA will be used in addition to the anti-VEGF injections. 

Professor Tunde Peto, the trial’s chief investigator, said the main objective was to reduce the number of injections, rather than stop them overall: "We don't really believe that this will completely negate the need for injections for the vast majority of people.”

She added: “But if you only need 1 or 2 or 3 injections less a year, it might be easier to pluck up the courage and go ahead with that….that would mean that you don't have to come so many times and go through with the injections."

Who is eligible to take part? 

The trial aims to recruit 360 participants from up to 20 NHS sites across the UK. Participants in the trial must be newly diagnosed with wet AMD in the study eye and aged 55 or over. If you fit the eligibility criteria, Dr Curran advised to speak to your consultant to find out whether your hospital is one of the participating sites. 

What about the side effects? 

Dr Curran said: “We have recently conducted a scoping review examining the use of levodopa in retinal disease, and across observational and early-phase studies, the drug was generally well tolerated with few reported adverse effects.

"Although large Phase three trials have not yet been conducted in this setting, levodopa has a well-established safety profile in Parkinson’s disease, and participants in this study will be closely monitored throughout.

"And it's been shown in previous research that this level of drug is sufficient to potentially reduce the number of injections needed and improve health at the back of the eye."

Patient involvement 

Alongside the trial the team is looking for people with lived experience of AMD to help shape how the research is conducted. If you do not fit the eligibility criteria, you could still be involved in this capacity. 

The team is looking for participants from across the UK. To get involved contact Dr Curran at k.curran@qub.ac.uk or LAMDARCT@belfasttrust.hscni.net