Category: Parkinson’s Disease: Clinical Trials
Objective: To determine if varenicline is effective for balance in Parkinson’s disease (PD).
Background: Incidence of falls resulting from imbalance is estimated at 68% for PD patients. While dopamine replacement effectively treats PD motor symptoms, it has little effect on balance. Limited research has shown that varenicline, a partial α4β2 agonist and full α7 agonist originally developed for smoking cessation, can improve gait function and balance for ataxia patients.
Method: This was an investigator-initiated, double-blind, placebo-controlled study testing varenicline for balance in PD. Participants with a confirmed diagnosis of PD were randomized to receive varenicline or placebo for eight weeks. After dose escalation, subjects took 1mg of drug twice daily until the end of study. Patients with severe tremor were excluded. Primary outcome was change on the Berg Balance Scale (BBS) from baseline to eight weeks. The BBS is a fourteen-item measure consisting of basic balance tasks. The study had a secondary, exploratory outcome of change in cognition, measured with the Frontal Assessment Battery (FAB) and the Mini Mental State Exam (MMSE) from baseline to eight weeks. The FAB is a six item measure of executive functioning.
Results: Thirty-six participants were randomized (82% men, 100% Caucasian). Average age was 71.0 years (±8.1). Average baseline motor MDS-UPDRS was 34.7 (±11.6). There were no significant differences between treatment groups on the BBS (F[1,28]=2.85,p =0.10) or FAB (F[1,24]=0.20,p=0.66), or MMSE (F[1,26]=2.66,p=0.12).
Conclusion: In contrast to previous research, the results did not suggest varenicline had any effect on balance in PD patients. Furthermore, varenicline did not appear to impact cognition. Perhaps if an objective measure of balance, such as posturography, had been used in place of the BBS the results would have been significant. However, the authors do not recommend further study.
To cite this abstract in AMA style:
D. Hall, S. Kapur, C. Vaughan, J. Hawkins, G. Stebbins. Varenicline for the Treatment of Postural and Gait Dysfunction in Parkinson’s Disease [abstract]. Mov Disord. 2020; 35 (suppl 1). https://www.mdsabstracts.org/abstract/varenicline-for-the-treatment-of-postural-and-gait-dysfunction-in-parkinsons-disease/. Accessed June 14, 2025.« Back to MDS Virtual Congress 2020
MDS Abstracts - https://www.mdsabstracts.org/abstract/varenicline-for-the-treatment-of-postural-and-gait-dysfunction-in-parkinsons-disease/