Pirepemat shows promise in trial for reducing risk of falls in Parkinson’s
Irlab shares updates at conference on 2 therapies, AI-based discovery platform
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- The oral therapy pirepemat, at an optimal blood concentration, was shown to significantly reduce falls in people with Parkinson's in a clinical trial.
- Developer Irlab is also assessing new tools to help drive its AI-based drug discovery platform.Â
- The company was tracking the use of amantadine for dyskinesia among more than 1,300 Parkinson's patients.
Treatment with pirepemat, an oral medication in the pipeline at Irlab Therapeutics AB, may help reduce the risk of falls in people with Parkinson’s disease when reaching its optimal blood concentration, according to newly shared data from a clinical trial in Europe.
“Topline results showed a markedly reduced fall rate across all treatment groups,” Irlab stated in a company press release, noting, however, that “no statistically significant difference was found [with pirepemat] vs. [a] placebo.” Still, the developer noted that “recurrent falls are among the most problematic symptoms in [Parkinson’s], with no satisfactory treatment.”
The company presented the findings from the Phase 2b trial at the AD/PD Alzheimer’s & Parkinson’s Diseases Conference, held March 17-21 in Copenhagen, Denmark.
The poster was titled “Results from REACT-PD – a randomised, placebo-controlled, multi-centre phase IIb study evaluating the efficacy of pirepemat on falls frequency in patients with Parkinson’s disease.”
At the conference, Irlab also shared new data on another medication — amantadine for dyskinesia, or uncontrolled movements in Parkinson’s — and on new tools being developed as part of its proprietary drug discovery process, which is driven by artificial intelligence (AI).
Parkinson’s is caused by the loss of dopaminergic neurons, the nerve cells that produce dopamine, a signaling molecule or neurotransmitter involved in motor control. The loss of those nerve cells results in the disease’s motor symptoms, including tremor and balance and gait issues, which can increase the risk of falls.
Use of pirepemat linked to 7 fewer falls per month for patients
Irlab’s experimental therapy Pirepemat (IRL752) is designed to reduce falls by strengthening nerve cell signaling in the brain. It modulates the activity of 5HT7 and alpha-2 receptor proteins on nerve cells, increasing the levels of dopamine and noradrenaline, another neurotransmitter.
According to the company, the treatment demonstrated good safety and tolerability in a Phase 1 trial in healthy volunteers, and in an exploratory Phase 2a trial in individuals with advanced Parkinson’s with cognitive impairment. The results also suggested that pirepemat could improve balance and reduce the risk of falls in people with Parkinson’s.
The Phase 2b REACT-PD trial (NCT05258071) enrolled 104 adults with Parkinson’s, who were randomly assigned to receive either 300 mg or 600 mg of pirepemat or a placebo, for 12 weeks, or about three months. A total of 90 participants completed the treatment.
A study abstract submitted for presentation at the meeting reported that patients treated with the therapy’s 600 mg dose experienced a 42% reduction in fall rate relative to those on the placebo. However, as noted by the company, this difference failed to reach statistical significance.
Further analyses dividing pirepemat-treated patients into three groups based on minimum blood therapy levels before the next dose showed that those with the medium blood exposure range experienced a significant reduction in fall rates, by 31%, compared with those given the placebo.
[These findings suggest that] pirepemat, in an optimal plasma concentration range, could significantly and clinically meaningfully reduce falls in [Parkinson’s disease].
This beneficial effect, corresponding to a reduction of seven falls per month, was not associated with changes in motor or balance assessments, per the developer.
Patients with lower and higher therapy concentrations in the blood did not see their fall rates significantly reduced.
Overall, these findings suggest that “pirepemat, in an optimal plasma concentration range, could significantly and clinically meaningfully reduce falls in PD [Parkinson’s disease],” Irlab stated in the release.
Amantadine use being tracked in Parkinson’s patients in real world
At the same meeting, Irlab researchers also shared findings on real-world use of amantadine for levodopa-induced dyskinesia, which are uncontrolled, involuntary movements in Parkinson’s patients often triggered by standard treatment.
Levodopa (L-DOPA) is the most effective treatment for easing Parkinson’s motor symptoms. However, its long-term use can cause side effects, including dyskinesia.
Amantadine is a suppressor of glutamate receptor proteins, of which extended-release oral formulations (Gocovri and Osmolex ER) are approved to treat levodopa-induced dyskinesia in Parkinson’s patients. By reducing glutamate signaling, amantadine may prompt neurons to release more dopamine. Glutamate is also a neurotransmitter.
In the poster “Amantadine for levodopa induced dyskinesias in PD: Prevalence, clinical correlates, and treatment outcomes in the PPMI study cohort,” researchers presented amantadine use patterns based on data from PPMI, an international registry study on Parkinson’s progression and biomarkers.
According to the study’s abstract, results from 1,340 participants, accessed in November 2025, indicated that about one-third reported dyskinesia at their last visit, and that 29% of these patients were treated with amantadine. Most participants received daily doses below the recommended effective dose.
Those on amantadine were more likely to have LRRK2, one of the most common genetic causes of Parkinson’s, and tended to have more severe Parkinson’s symptoms, including motor symptoms such as dyskinesia, cognitive impairment, and more impaired activities of daily living.
Additionally, motor function was generally better among those treated with amantadine, as assessed by clinicians using the MDS-UPDRS part 3 score. Still, one-third of those who started amantadine eventually stopped the treatment. These patients generally experienced more severe symptoms than those who continued the treatment, per the developer.
AI tools are helping drive Irlab’s drug discovery platform
In another poster at the conference, the company presented new behavioral assessment tools based on its AI-driven drug discovery platform, called Integrative Screening Process (ISP). That poster was titled “Searching for novel CNS therapies in Parkinson’s and Alzheimer’s disease using Integrative Screening process (ISP): An AI/ML driven phenotypic drug discovery platform.”
ISP is a target-based platform that combines data from animal models, human tissue samples, and lab studies, and uses AI tools to predict drug candidates with the highest potential for specific diseases.
Irlab shared an advancement in tools based on AI to identify behavioral parameters captured by video recordings. This novel technology may help more accurately predict response to novel compounds, according to the developer.
Several ISP-derived programs are now in development by the company. These include pirepemat for falls and mesdopetam (IRL790) for the treatment of levodopa-induced dyskinesia. There’s also a project developing dopamine receptor agonists that can treat Parkinson’s motor symptoms with once-daily oral administration as an alternative to available treatments.
