Alzheimer's prevention seen promising as drug cures fail

 

NEW YORK

Three studies set to explore the use of experimental drugs that may become the first to change the course of Alzheimer's disease aren't looking to cure the illness. Their goal is to prevent it altogether.

The independent trials will begin in 2013 and run for three to five years, testing as many as five drugs in almost 1,500 volunteers who haven't shown any of Alzheimer's mind-altering symptoms, yet carry a strong genetic risk for the disease or display early physical evidence in the brain. A decision on the final study drug is expected in December.

The newest strategy abandons a drive that failed to stop Alzheimer's once memories recede. Instead, as with heart disease, scientists are exploring if the mind-robbing ailment can be prevented or at least delayed using drugs that act roughly like Pfizer's Lipitor and other statins. The idea, driven by new information that tracks the disease's progression back through time, is to act years before symptoms occur to rid the brain of proteins that can later destroy nerve cells.

"We now can see changes 10 to 15 years before symptoms develop," said Neil Buckholtz, director of the division of neuroscience at the National Institute on Aging in Bethesda, Maryland. "If you can stop them, you have a chance of slowing down or possibly even stopping progression."

A breakthrough can't come soon enough. The number of Alzheimer's cases globally is expected to double within 20 years as the world's population ages, to as many as 65.7 million people in 2030 and 115 million by 2050, the Geneva- based World Health Organization said in April.

At the same time, studies completed as recently as the last three months involving drugs made by Pfizer and Johnson & Johnson, the world's two biggest makers of health products, and Eli Lilly & Co. showed virtually no progress in slowing or stopping the disease in patients in the later stages of the disease.

Lilly said on Oct. 8 that its drug, solanezumab, provided no benefit to advanced victims in a trial. The research did suggest the medicine may help in a small way in those with early symptoms. J&J and Pfizer reported on Sept. 11 that while their drug, bapineuzumab, showed signs of reducing physical damage, it didn't affect symptoms.

The next step, Buckholtz said, is to determine if pushing the use of drugs like these back in time, when the disease is just beginning to form, will make a difference.

"Really what's happened is over the past 10 years, investigators have tried to go earlier and earlier in the disease process," Buckholtz said.

Enabling researchers to get an ever earlier look at the progression of Alzheimer's has been the development of new imaging agents, such as Pittsburgh Compound B or PiB, that highlights the activity of beta amyloid, the hallmark protein that makes up the brain's tell-tale tangles.

Researchers studying those with a genetic propensity for early Alzheimer's, which can take hold by age 40, have also tracked changes in brain size and cerebrospinal fluid that can occur as early as 25 years before symptoms develop.

That work has allowed scientists to think of Alzheimer's as a kind of chain reaction, much like that leading up to heart disease, said Randall Bateman, a neurologist at the Washington University in St. Louis who is leading one of the three studies.

"The questions are how long do you treat, when do you start, and how do you measure effectiveness," Bateman said in a telephone interview. "It took thousands of patients over many years to show statins have a benefit in heart disease. We're going as early in Alzheimer's as we practically can."

While the three studies won't help those with the disease now, they may be able affect the lives of generations to come, the researchers said.

Researchers in two of the trials have already determined they'll use Lilly's solanezumab and two products made by Roche Holding that are in earlier stages of testing.

One of these trials is led by Bateman and the other by Eric Reiman of the Banner Alzheimer's Institute in Phoenix. These studies will test about 460 people, all of whom have rare genetic mutations that almost certainly will trigger the disease early in their lives.

Bateman's team will, over at least three years, test as many as three drugs in 160 people with parents who fell victim to the disease early.

Reiman's group will study a group of families in Colombia who often suffer severe memory loss by their early 40s. The five-year $100 million study has interim tests that may indicate whether the drug is having an effect within two years.

The third trial, dubbed A4, will be conducted by a team led by Reisa Sperling at Harvard Medical School in Boston. It will test a drug on about 1,000 older people over three years whose brains show the beginning of physical signs of Alzheimer's characteristic beta amyloid protein deposits, and who haven't yet displayed the disease's symptoms.

A4 is the most representative of the general population, and researchers plan to decide in December which drug they will test, Sperling, a neurologist, said in a telephone interview. She declined to say which medicines are being considered.

"It's challenging to make a decision," she said. "We're looking for a combination of evidence of biologic activity and a hint of clinical efficacy. That's much more difficult because the drugs right now are all being tested in dementia, so it's hard to know how to extrapolate the findings back 10 years."

The researchers also want to make sure the drugs are safe, because the study group is composed of clinically normal older adults, Sperling said.

The trials are exploratory, said Maria Carrillo, the vice president of medical and scientific relations at the Alzheimer's Association, a Chicago-based advocacy organization. Any drug that's at least being studied in a Phase 2 trial targeting amyloid is fair game, she said.

"The question is, if we can really effect and impact that in a significant way," Washington University's Bateman said. "It would be a fantastic breakthrough for these family members, and having that demonstration we can treat and prevent the disease will embolden the field."

Arts & Entertainment
Madonna in her music video for 'Like A Virgin'
music... and other misheard song lyrics
Extras
indybestFake it with 10 best self-tanners
Sport
Peter Moores was criticised for failing to handle top players when he last led the England team
sportFive years after being sacked from the job, Peter Moores to be named a cricket coach
News
Much of the colleges’ land is off-limits to locals in Cambridge, with tight security
educationAnd has the Cambridge I knew turned its back on me?
VIDEO
Have you tried new the Independent Digital Edition iPad app?
Sport
Steven Gerrard had to be talked into adopting a deeper role by his manager, Brendan Rodgers
sportThe city’s fight for justice after Hillsborough is embodied in Steven Gerrard, who's poised to lead his club to a remarkable triumph
News
The energy drink MosKa was banned for containing a heavy dose of the popular erectile dysfunction Levitra
news
Environment
People are buying increasing numbers of plants such as lavender to aid the insects
environmentGardeners rally round the endangered bumblebee
News
Ida Beate Loken has been living at the foot of a mountain since May
newsNorwegian gives up home comforts for a cave
Extras
indybest10 best gardening gloves
Sport
Australia's Dylan Tombides competes for the ball with Adal Matar of Kuwait during the AFC U-22 Championship Group C match in January
sportDylan Tombides was diagnosed with testicular cancer in 2011
Arts & Entertainment
tvIt might all be getting a bit much, but this is still the some of the finest TV ever made, says Grace Dent
News
Posted at the end of March, this tweeted photo was a week off the end of their Broadway shows
people
News
peopleStar to remain in hospital for up to 27 days to get over allergic reaction
Arts & Entertainment
The Honesty Policy is a group of anonymous Muslims who believe that the community needs a space to express itself without shame or judgement
music
Independent
Travel Shop
the manor
Up to 70% off luxury travel
on city breaks Find out more
santorini
Up to 70% off luxury travel
on chic beach resorts Find out more
sardina foodie
Up to 70% off luxury travel
on country retreats Find out more
Have you tried new the Independent Digital Edition iPad app?
Independent Dating
and  

By clicking 'Search' you
are agreeing to our
Terms of Use.

iJobs Job Widget
iJobs General

Apprentice IT Technician

£150.00 per week: QA Apprenticeships: This company is a company that specializ...

1st Line Technical Service Desk Analyst IT Apprentice

£153.75 per week: QA Apprenticeships: This company is an innovative outsourcin...

1st Line Helpdesk Engineer Apprentice

£150.00 per week: QA Apprenticeships: This company has been providing on site ...

Sales Associate Apprentice

£150.00 per week: QA Apprenticeships: We've been supplying best of breed peopl...

Day In a Page

How I brokered a peace deal with Robert Mugabe: Roy Agyemang reveals the delicate diplomacy needed to get Zimbabwe’s President to sit down with the BBC

How I brokered a peace deal with Robert Mugabe

Roy Agyemang reveals the delicate diplomacy needed to get Zimbabwe’s President to sit down with the BBC
Video of British Muslims dancing to Pharrell Williams's hit Happy attacked as 'sinful'

British Muslims's Happy video attacked as 'sinful'

The four-minute clip by Honesty Policy has had more than 300,000 hits on YouTube
Church of England-raised Michael Williams describes the unexpected joys in learning about his family's Jewish faith

Michael Williams: Do as I do, not as I pray

Church of England-raised Williams describes the unexpected joys in learning about his family's Jewish faith
A History of the First World War in 100 moments: A visit to the Front Line by the Prime Minister's wife

A History of the First World War in 100 moments

A visit to the Front Line by the Prime Minister's wife
Comedian Jenny Collier: 'Sexism I experienced on stand-up circuit should be extinct'

Jenny Collier: 'Sexism on stand-up circuit should be extinct'

The comedian's appearance at a show on the eve of International Women's Day was cancelled because they had "too many women" on the bill
Cannes Film Festival: Ken Loach and Mike Leigh to fight it out for the Palme d'Or

Cannes Film Festival

Ken Loach and Mike Leigh to fight it out for the Palme d'Or
The concept album makes surprise top ten return with neolithic opus from Jethro Tull's Ian Anderson

The concept album makes surprise top ten return

Neolithic opus from Jethro Tull's Ian Anderson is unexpected success
Lichen is the surprise new ingredient on fine-dining menus, thanks to our love of Scandinavian and Indian cuisines

Lichen is surprise new ingredient on fine-dining menus

Emily Jupp discovers how it can give a unique, smoky flavour to our cooking
10 best baking books

10 best baking books

Planning a spot of baking this bank holiday weekend? From old favourites to new releases, here’s ten cookbooks for you
Jury still out on Manchester City boss Manuel Pellegrini

Jury still out on Pellegrini

Draw with Sunderland raises questions over Manchester City manager's ability to motivate and unify his players
Ben Stokes: 'Punching lockers isn't way forward'

Ben Stokes: 'Punching lockers isn't way forward'

The all-rounder has been hailed as future star after Ashes debut but incident in Caribbean added to doubts about discipline. Jon Culley meets a man looking to control his emotions
Mark Johnston: First £1 million jackpot spurs him on

Mark Johnston: First £1 million jackpot spurs him on

The most prize money ever at an All-Weather race day is up for grabs at Lingfield on Friday, and the record-breaking trainer tells Jon Freeman how times have changed
Ricky Gervais: 'People are waiting for me to fail. If you think it's awful, then just don't watch it'

Ricky Gervais: 'People are waiting for me to fail'

As the second series of his divisive sitcom 'Derek' hits screens, the comedian tells James Rampton why he'll never bow to the critics who habitually circle his work
Mad Men series 7, TV review: The suits are still sharp, but Don Draper has lost his edge

Mad Men returns for a final fling

The suits are still sharp, but Don Draper has lost his edge
Google finds a lift into space will never get off the ground as there is no material strong enough for a cable from Earth into orbit

Google finds a lift into space will never get off the ground

Technology giant’s scientists say there is no material strong enough for a cable from Earth into orbit