Effects of liraglutide in the treatment of severe obesity in a young patient with parkinson's disease

The Glucagon-like peptide-1 (GLP-1) analog exert disease-modifying effects in patients with Parkinson’s disease (PD). Nonetheless, the significant improvement in motor performance was paralleled by significant reduction in body weight in exenatide-treated PD, so that it could argued that levodopa pharmacokinetics could have been improved by either body weight loss or by other GLP-1-related. We describe a 42-year-old female Italian PD patient with a 2-year history of PD, who presented a few month after the onset (October 2017) with III class obesity (BMI 47 kg/m2). To assess the effects of body weight loss both on efficacy of pharmacological treatment and on PD symptoms, the GLP-1 analog Liraglutide was prescribed for obesity (according to Italian guidelines) in adjunct to pramipexole PR 1 mg/day and levodopa/benserazide 400mg/day. Plasma Levodopa levels were investigated. The overall body weight loss of 29 kg (-21% , from 138 kg to 129 kg) was associated to a significant improvement in the motor disability was paralleled by a 2-fold increase in the area-under-the curve (AUC from 119 to 235 (ug/ml)*min and the Cmax (from 1.45 to 2.98 ug/mL). The use GLP-1 analog Liraglutide is able to improve PD motor disability in the short-term, likely because of optimized levodopa pharmacokinetics. It remains to be elucidated whether this is a consequence of either body weight loss or greater levodopa intestinal absorption or both.