Fasudil (ROCK-PD)

The research record

This is the project's file for this landmark, as written and checked. Sources are listed at the end; anything not yet confirmed is marked "Not yet verified".

Who

Paul Lingor and the Technical University of Munich, with 13 German sites in the German Parkinson competence network. Funded by the German research ministry (BMBF, grant 01EN2005). The protocol's first author is A. W. Wolff. Lingor is named as an inventor on a fasudil patent for ALS.

What happened

ROCK (Rho kinase) is an enzyme involved in cell shape, inflammation and cell death. In rodent and cell models of Parkinson's, fasudil protected dopamine neurons, reduced clumping of alpha-synuclein (landmark 5) and improved movement, according to the protocol paper. Its active metabolite crosses into the brain.

ROCK-PD (NCT05931575) randomised, double-blind: oral fasudil at 22 mg or 44 mg per dose, or placebo, for 22 days with follow-up to day 50. Doses are taken twice daily on days 2–21 and once on days 1 and 22, so about 44 or 88 mg a day (the registry labels the arms "low" 88 mg and "high" 44 mg a day, which looks inverted). Participants have probable Parkinson's, Hoehn and Yahr stage 1–3, are aged 30–80 and stable on medication. The protocol planned 75; the registry shows 81 enrolled. The primary outcome is a combined measure of intolerance or treatment-related serious adverse events, tested for non-inferiority to placebo. Symptom scores (MDS-UPDRS) are secondary. Registered start: 11 September 2023; completion 24 August 2026.

Why it moved us toward a cure

It brings a multi-effect candidate (neuron protection plus less synuclein clumping) into the first controlled test in Parkinson's. At three weeks it can only show whether the dose is tolerable, which is what a later slowing trial would need.

Outcome

Open. Completed, no results on ClinicalTrials.gov as of 19 Oct 2026 and no publication found.

Sources

• ROCK-PD protocol, Front Aging Neurosci 2024, DOI 10.3389/fnagi.2024.1308577
• ClinicalTrials.gov NCT05931575 (API, 19 Oct 2026; status verified September 2026)
• Tatenhorst et al., Acta Neuropathol Commun 2016, DOI 10.1186/s40478-016-0310-y (fasudil and synuclein aggregation)
• Not yet verified: the allocation ratio (the earlier "1:1:1" was not found in the protocol abstract or registry); any topline result; why enrolment exceeded the planned 75; whether a longer slowing trial is planned.