Microbiota Intervention for Parkinson's Disease

(MICRO-PD Trial)

DR
EB
RP
HM
Overseen ByHannah McCarthy Potter, BA
Age: 18+
Sex: Any
Trial Phase: Phase 1 & 2
Sponsor: University of California, San Francisco
Must be taking: Levodopa
Approved in 6 JurisdictionsThis treatment is already approved in other countries

What You Need to Know Before You Apply

What is the purpose of this trial?

This trial explores how altering gut bacteria might help people with Parkinson's disease (PD) manage their symptoms more effectively. Researchers believe gut bacteria can influence the effectiveness of PD medications and may even relate to the disease's symptoms. Participants will receive either the antibiotic rifaximin, which targets gut bacteria, or a placebo to determine if this change can improve PD symptoms and medication effectiveness. Ideal candidates for this trial have Parkinson's disease, experience symptom fluctuations, and are stable on levodopa therapy, a common PD medication. As a Phase 1, Phase 2 trial, this research aims to understand how the treatment works in people and measure its effectiveness in an initial, smaller group, offering participants a chance to contribute to groundbreaking research.

Will I have to stop taking my current medications?

The trial does not specify if you need to stop taking your current medications, but it requires participants to be stable on levodopa therapy. This suggests you may need to continue your current levodopa treatment.

Is there any evidence suggesting that this trial's treatments are likely to be safe?

Research has shown that rifaximin, an antibiotic that remains in the gut, is generally safe for people. Studies involving individuals with Parkinson's disease (PD) have found that rifaximin can alter gut bacteria without causing major side effects. This is reassuring because the FDA has already approved rifaximin for other uses, such as treating traveler's diarrhea, which supports its safety.

In past studies, participants taking rifaximin did not report significant side effects, indicating it was well-tolerated. The drug primarily acts in the gut and minimally enters the bloodstream, likely reducing the risk of systemic side effects. This makes it a promising option for those interested in treatments targeting the gut-brain connection in Parkinson's disease.12345

Why do researchers think this study treatment might be promising for Parkinson's disease?

Unlike the standard treatments for Parkinson's disease, which typically focus on managing symptoms with medications like levodopa and dopamine agonists, Rifaximin offers a novel approach by targeting the gut microbiota. Researchers are excited about Rifaximin because it is an antibiotic that could potentially modify gut bacteria, which is believed to play a role in the disease's progression. By altering the microbiota, Rifaximin might address underlying factors contributing to Parkinson's, offering a fresh avenue for treatment beyond symptom management.

What evidence suggests that this trial's treatments could be effective for Parkinson's disease?

Research suggests that rifaximin, which participants in this trial may receive, might help reduce movement problems in people with Parkinson's disease (PD). One study found that PD patients who took rifaximin experienced a noticeable decrease in the severity of their movement issues. Another report showed that rifaximin increased certain beneficial gut bacteria in PD patients, which could be helpful. A small study also indicated that rifaximin reduced movement fluctuations in patients with small intestinal bacterial overgrowth (SIBO), a condition some people with PD have. While some studies have mixed results, these findings suggest that rifaximin could be promising for managing PD symptoms by changing gut bacteria. Participants in this trial may also receive a placebo as part of the study's control arm.12678

Who Is on the Research Team?

CT

Caroline Tanner, MD, PhD

Principal Investigator

University of California, San Francisco

Are You a Good Fit for This Trial?

Inclusion Criteria

You are currently taking levodopa for your condition and it is working well for you.
You have Parkinson's disease.
You have Parkinson's disease.
See 1 more

Exclusion Criteria

Pregnant individuals
You have a long-term gastrointestinal (stomach and intestines) disease.
You have taken antibiotics or probiotics recently.
See 1 more

Timeline for a Trial Participant

Screening

Participants are screened for eligibility to participate in the trial

2-4 weeks

Cross-sectional Analysis

Correlate the microbiome profile with the clinical phenotype of PD and medication response

Not specified

Randomized Controlled Trial

Evaluate the effect of microbiome manipulation on clinical phenotype and medication response

2 weeks
Multiple visits (in-person and virtual)

Follow-up

Participants are monitored for safety and effectiveness after treatment

4 weeks

What Are the Treatments Tested in This Trial?

Interventions

  • Placebo
  • Rifaximin
How Is the Trial Designed?
2Treatment groups
Experimental Treatment
Placebo Group
Group I: InterventionExperimental Treatment1 Intervention
Group II: PlaceboPlacebo Group1 Intervention

Rifaximin is already approved in United States, Canada, European Union, India for the following indications:

🇺🇸
Approved in United States as Xifaxan for:
🇨🇦
Approved in Canada as Zaxine for:
🇪🇺
Approved in European Union as Xifaxan for:
🇮🇳
Approved in India as Ciboz and Xifapill for:

Find a Clinic Near You

Who Is Running the Clinical Trial?

University of California, San Francisco

Lead Sponsor

Trials
2,636
Recruited
19,080,000+

Nova Southeastern University

Collaborator

Trials
103
Recruited
12,000+

Gateway Institute for Brain Research

Industry Sponsor

Trials
2
Recruited
140+

Citations

1.pubmed.ncbi.nlm.nih.govpubmed.ncbi.nlm.nih.gov/36359864/
Rifaximin Modifies Gut Microbiota and Attenuates ...In the patients with PD, 7-day rifaximin treatment caused an increase in the relative abundance of Flavonifractor 6 months after treatment, and ...
Treating Bacterial Overgrowth in Parkinson's DiseaseThe primary endpoint is to assess the effect of rifaximin treatment to decrease "off" time in SIBO-positive PD patients.
Review Modulation of the Microbiome in Parkinson's DiseaseIn a small, open-label study of patients with small intestinal bacterial overgrowth (SIBO), rifaximin use was associated with fewer motor fluctuations and ...
Rifaximin Modifies Gut Microbiota and Attenuates ...Although short-term rifaximin treatment did not exert a significant beneficial effect on patients with PD, the results indicated that rifaximin ...
Gut microbiota modification with rifaximin modulates severity ...Results: PD patients treated with rifaximin presented a significant reduction in the severity of PD motor symptoms, as indicated by the scores in part III and ...
Rifaximin: Uses, Interactions, Mechanism of ActionRifaximin is a rifamycin-based non-systemic antibiotic used for the treatment of gastrointestinal bacterial infections, such as traveler's diarrhea and ...
DNA-dependent RNAP inhib Trials2016-004159-56: Efficacy and safety of mesalazine, rifaximin, alone or as extemporary combination, in the treatment of symptomatic uncomplicated ...
Real World Evidence | XIFAXAN® (rifaximin)Compared with patients given XIFAXAN without delay, other treatment subgroups showed increased odds of 30-day risk of OHE rehospitalization and increased ...
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