Compositions and methods for treating Parkinson's disease (PD) and related disorders
The present disclosure is in the field of pharmaceutical compositions suitable for the treatment of diseases in mammals. The disclosure provides novel compositions comprising non-pathogenic fecal microbes or a sterile fecal filtrate for treating Parkinson's disease and related diseases. The disclosure also provides methods for treating a subject with the compositions disclosed herein.
1. A method for treating Parkinson's disease (PD) in a human subject in need thereof, the method comprising orally administering to the human subject one or more compositions comprising (i) a pharmaceutically active induction dose of a therapeutic composition comprising a fecal bacterial preparation comprising a community of live non-pathogenic fecal bacteria from a stool or portion thereof of a healthy human donor, and (ii) a second active agent, wherein the subject is further administered a maintenance dose of the therapeutic composition, wherein the maintenance dose is lower than the induction dose, wherein at least two doses of the therapeutic composition are administered to the subject over a two-week period, and
wherein the human subject experiences an improvement in at least one symptom selected from the group consisting of tremor, slowed movement, rigid muscles, impaired posture and balance, loss of automatic movements, speech changes, and writing changes within 15 weeks after initiating treatment.
2. The method of claim 1 , wherein the subject has PD at a clinical stage selected from the group consisting of Stages I to V.
3. The method of claim 1 , wherein the therapeutic composition comprises a non-selected fecal microbiota.
4. The method of claim 3 , wherein the fecal microbiota comprises a donor's substantially entire fecal microbiota.
5. The method of claim 1 , wherein the fecal bacteria are from synthetic fecal material.
6. The method of claim 1 , wherein the method reduces the rate of progression of one or more of the at least one symptom in the subject.
7. The method of claim 1 , wherein the therapeutic composition is administered at least twice weekly for at least three weeks.
8. The method of claim 1 , wherein the therapeutic composition is administered at least twice weekly for at least 4 weeks.
9. The method of claim 1 , wherein the therapeutic composition is formulated as a delayed or gradual enteric release form.
10. The method of claim 1 , wherein the therapeutic composition is in a liquid, frozen, freeze-dried, spray-dried, foam-dried, or powder form.
11. The method of claim 1 , wherein the therapeutic composition comprises a cryoprotectant selected from the group consisting of polyethylene glycol, skim milk, erythritol, arabitol, sorbitol, glucose, fructose, alanine, glycine, proline, sucrose, lactose, ribose, trehalose, dimethyl sulfoxide (DMSO), glycerol, and a combination thereof.
12. The method of claim 1 , wherein the subject is pretreated with an antibiotic prior to administration of the therapeutic composition.
13. The method of claim 1 , wherein the second active agent comprises a non-fecal microbiome based therapy.
14. The method of claim 1 , wherein the second active agent is selected from the group consisting of bromocriptine, benztropine, levodopa, ropinirole, pramipexole, rotigotine, cabergoline, entacapone, tolcapone, amantadine, and selegiline.
15. The method of claim 1 , wherein the second active agent comprises levodopa, a dopamine agonist, an inhibitor of enzymes that inactivate dopamine, a monoamine oxidase B (MAO B) inhibitor, a catechol-O-methyl transferase (COMT) inhibitor, an anticholinergic, amantadine, or estrogen.
16. The method of claim 1 , wherein the second active agent is a dopamine agonist.
17. The method of claim 1 , wherein the second active agent is a monoamine oxidase B (MAO B) inhibitor.
18. The method of claim 1 , wherein the second active agent is a catechol-O-methyl transferase (COMT) inhibitor.
19. The method of claim 1 , wherein the second active agent is an anticholinergic.
20. The method of claim 1 , wherein the second active agent comprises a bacterial isolate.
21. The method of claim 1 , wherein the second active agent comprises purified bacteria belonging to a genus selected from the group consisting of: Clostridium, Collinsella, Dorea, Ruminococcus, Coprococcus, Prevotella, Veillonella, Bacteroides, Bacillus and a combination thereof.
22. The method of claim 1 , wherein the induction dose is administered to the human subject twice-a-day for 4 days, and the maintenance dose is administered to the human subject twice-a-day every other day for 10 days.
23. The method of claim 1 , wherein the therapeutic composition and the second active agent are in the same composition.
24. The method of claim 1 , wherein the therapeutic composition and the second active agent are in different compositions.