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NS-Park network
Clinical research network for Parkinson’sdisease and Movement Disorders
Jean-Christophe Corvol
Maladie de ParkinsonPrévalence : 2% de la population > 65 ans
150 000 patients en France
Corps de Lewy
Dégénérescence des neurones
dopaminergiques
�Akinésie
�Rigidité
�Tremblement
Syndromes apparentés :
Atrophie multisystématisée, paralysie supranucléaire progressive,
Dégénérescence cortico-basale, démence à corps de Lewy…
•Gait failure•Dementia
Parkinson’s disease
Evolution and treatment
De Novo PD
•Fluctuations•Dyskinesia
Honeymoon
Dopaminergic
drugs
Extra-dopaminergic
lesions
Deep brain
stimulation
Dopaminergic lesions
Neuroprotection
Prevention of motor complications
Treatment of motor complications
Non motor symptoms
PD’s major challenges
NEJM 2009
Disease modifiers
SNCAMAPT
LRRK2
Physiopathology Early diagnosis
Rating scales
Study design
Lancet 2011
Brain imaging
Lancet Neurol 2012 Brain 2013
Personnalized medicine
Medical strategiesDevicesAnn Neurol 2011
Rare diseases
Brain 2009, Lancet Neurol, in press
Motor symptoms
Non motor symptoms
Lancet Neurol, 2012
New targets
Medical strategies
DevicesBiomarker of progression
Task1
Task2
Task3
Task4
Task5
Early diagnosis and genetics of PD
Motor symptoms and complications of PD
Non-motor symptoms of PD
Late PD
Rare movement disorders
Early
diagnosis
Prevention
Treatment
Rescue
New targets
NS-Park - Project
WG1
WG2
WG3
WG4
WG5
WorkingGroups
Historical NS-Park centers
CIC & movement disorder Clinic
Bordeaux Pr F Tison
Clermont Pr F Durif
Créteil Pr P Remy
Dijon Pr M Giroud
Grenoble Pr P Krack
Lille Pr A Destee
Lyon Pr E Broussolle
Marseille Pr JP Azulay
Montpellier Pr C Geny
Nantes Pr P Derckinderen
Paris Pr JC Corvol
Poitier Pr JL Houetto
Rouen Pr D Maltête
Strasbourg Pr C Tranchant
Toulouse Pr O Rascol
Associated centers
Amiens Pr P Krystkowiak
Aix Dr F Viallet
Besançon Pr P Remy
Caen Pr G Defer
Limoges Dr F Torny
Nancy Dr RN Gospodaru
Nice Dr C Giordana
Reims Dr A Doé de Maindreville
24 PD expert centers
16 CIC
> 12,000 patients
Guichet unique:
2 chefs de projet
Working groups Transversal tasks
Steering committee
CoordinationChair: Pr Corvol, Pr Rascol, Pr Durif
24 NS-Park centers + Partners
Early diagnosis
Genetics
Chair: Pr Brice, Pr
Destée,
Motors
complications
Chair: Pr Rascol,
Pr Corvol,
Non motor
symptoms
Chair: Pr Krack,
Pr Durif, Dr
Brefel-Courbon,
Pr Houeto, Pr
Vérin
Late PD
Chair: Pr Azulay,
Pr Dujardin, Dr
Welter
Rares diseases
and other
movement
disorders
Chair: Pr Anheim,
Pr Meissner, Pr
Vidailhet
Databases
Chair: Pr Corvol,
Pr Meissner, Pr
Lehericy, Pr
Thobois, Pr
Remy, Dr
Eusebio, Pr
Burbaud
Relationships
with
preclinical
teams and
industry
Chair: Pr Tison,
Pr Remy
Education
Chair: Pr
Tranchant, Pr
Defebvre
Clinical trials
methods
Rating scales
Chair: Pr Rascol,
Dr Devos
NS-Park - Expertise
• Basic research (Paris, Marseille, Lyon)
• Preclinical research (Neuratris, Bordeaux)
• DBS (Grenoble)
• Study design (Toulouse)
• Rating scales (MDS-UPDRS, ECMP, LARS…)
• Brain imaging (CATI)
• Dedicated biobank (BioCollection)
• Project managers– Grant preparation
– Feasibility
– Hospital costs, agreements
– Study coordination and follow-up
• European network
NS-Park – Major publications
EU RCT (France-Germany)
Device
PI: Y Agid (Paris)
NEJM 20138
French multicenter RCT
Drug – non motor
PI: Devos (Lille)
Lancet Neurol 201211
International (UK-Germany-
France-Netherlands-USA)
Genetics. PI: A. Brice (Paris)Lancet 201112
French multicenter RCT
Drug - motor
PI: Rascol (Toulouse)
Neurology, 20137
EU RCT (France-Germany-UK)
Rare disease
PI: G. Bensimon (Paris)Brain 200911
French multicenter RCTs
Rare disease
PI: F Durif (Clermont Ferrand)Neurology, 20136
NS-Park - Activity
Phase II
40%
Phase III
27%
Phase IV
10%
Other*
23%
30 clinical studies
0
2
4
6
8
10
12
14
16
18
Academic Industry
Phase IV
Phase III
Phase II
OtherNu
mb
er
of
stu
die
s
*cohortes, rating scale validation
Motor
37%
Dyskinesia
27%
Non motor
20%
Rare MD
13%
Disase
modifying
3%
International
47%National
53%
NS-Park – Ongoing studies
Etudes en cours
• Académiques
– PREMANDYSK (Toulouse, Rascol) prévention dyskinésies
– BADGE-PD (Paris, Corvol), pharmacogénétique
– APATHIE (Clermont, Durif), rasagiline
– BEAD-PD (Paris, Corvol), pharmacogénétique
• Etudes industrielles
– Completed: Novartis, Addex, Allon, BIA
– Phase II, salivation, NeuroHealing
Etudes à venir, collaborations
• Académiques– MSA-DOPS (Toulouse, Rascol)
– PREDISTIM (Lille, Devos)
– STARTLATE (Paris, Welter), stimulation
• Collaborations industrielles– Biomarqueurs, IPSEN, SANOFI
– Comp. motrices, IPSEN
– Phase I, AFFIRIS
– Phase II, CHELSEA, APOPHARMA,
– Phase II-III, LILLY
– Phase III, STADA
– Autres: ONO, Ad Scientiam, Neurolixis, B&A therapeutics…
ONO pharma
Ipsen
Lundbeck
Sanofi RD
Chelsea
Lilly
STADA
Ipsen RD
Neurohealing
AFFIRIS
Neurolixis
Apopharma
B&A therapeutics
POC, phase II
Phase III
Repositionning
Phase IVPersonalized
medicine
Drug development
Biomarkers
Preclinical
models
Basic research
Physiology
NS-Park pipeline
NS-Park – Database and registry
Clinical database
Medical activity, registry, cohorts, CRF
Imaging database
SOPs for brain MRI and DATscan
Centre d’Analyse et de Traitement
des Images
Biobank
Parkinson’s disease biobank
Number of clinical
trials in EU in
Parkinson’s disease
Source: ClinicalTrial.gov
(2014)
NS-Park – European strategy
Austria:
Werner Poewe
Spain:
Eduardo Tolosa
Italy:
Paolo Barone
David Burn
T. Klockgether
O Rascol: Chair of the MDS European Section:
⇒ Identify EU networks in the field of PD and movement disorders
⇒Joint application to EU calls (Horizon 2020)
NS-Park – European strategy
PD Genetics
DenDRON
KKS
Other EU networks
Neuratris
CATI (Center
for Image
Acquisition
and
Processing)
BioCollection
Clinical research infrastructures
Patients associations
AMADYSFrance
Parkinson APTES
ARAMISEPSP France
Reference Centers rare
diseases
MSAGilles de la
Tourette PSP
GeneticDystonia
Industrial Partners
Shared with INIs
Legal counseling
EU lobbying
Education
Quality
Patents
Clinical
Novartis
Merck
Addex
Kyowa
Chelsea
UCB
Neuroderm
…
Preclinical
Ipsen
Sanofi
UCB
ONO
Medtronic
…
FCRIN platforms
Data managment
Statistics
Methodology
Drug manufacturing
FCRIN Office
Why use NS-Park?
• EU grant (Horizon 2020) in PD or aging
• Clinical trials in PD or movement disorders
– POC studies, design, feasibility, recruitment,
follow-up…
• Biomarker research (wet or imaging)
• Device development for PD
• Rare patients: genetic forms (LRRK2, GBA…),
rare movement disorders
How to use NS-Park?
• Coordination: � JC Corvol (Pitié-Salpêtrière)
� F Durif (Clermont-Ferrand)
� O Rascol (Toulouse)
• Project managers:– Véronique Chaigneau or Estelle Dellapina
– Tel: 05.61.77.24.07
– Email: reseauNSPARK@inserm.fr
• Web site: http://reseau-cic-parkinson.inserm.fr/
NS-Park - Funds and budget
Coordination
23%
Centers
24%Driving
initiatives
19%
Databases
19%
Shared with
other INI
15%
0
50
100
150
200
250
300
350
400
2014 2015 2016 2017 2018
FCRIN Other incomes
Inco
me
s(k
€)
Inco
me
s(k
€)
0
50
100
150
200
250
300
2014 2015 2016 2017 2018
CRA in centers
Project coordination
Valorization
Industrial fees
INSERM
2 project managers
+ operating costs
to sustain NS-Park
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