Drug for Alzheimer’s unlikely in near future

Drug for Alzheimer's likely
A new drug for Alzheimer’s has recently made the headlines after scientists labelled it the best news in dementia research for the last twenty five years.

The drug, called ‘Aducanumab’, was discovered by scientists when they were testing different chemicals from human immune ‘memory cells’ against amyloid beta – the toxic plaque that builds up in the brain of sufferers.

Alzheimer’s is one of the most common types of dementia, which affects at least 850,000 people in the Britain alone. The condition causes confusion, loss of speech and memory problems. Currently there are no drugs available to sufferers that can reverse the damage caused by the disease.

In tests, Aducanumab appeared to be effective against amyloid beta, turning the brain’s immune system against the noxious build ups of protein and reducing it. When the drug is injected, around 1 in 1,000 particles crosses over into the brain and binds to the clusters of amyloid beta before attracting the brain’s own immune cells (microglia), which clear the amyloid beta away. The drug also appeared to be effective at halting cognitive decline by around 50%, or stopping it entirely for some participants. However, testing of the new drug is in its very early stages – with the initial trial, reported in the journal ‘Nature’, lasting just one year and involving only 165 patients.

Although small scale, the initial trial for Aducanumab looks promising – although even if larger trials prove successful, the drug is unlikely to be available on the NHS for at least 5 years. Image source: Nature

With promising early results, a larger scale trial is now being set up which will involve 2,700 patients, all in the early stages of the condition. Scientists will need to show that the benefits of the drug outweigh the side effects which around quarter of the patients experienced – include a build up of fluid outside the participants’ brain cells. If the trial is successful, the treatment could be available on the NHS – but not for at least another  5 years, according to Alzheimer’s Research UK. Scientists are also well aware that historically, where the results of small scale trials have been promising, larger trials have been unsuccessful.

Aducanumab is not the only treatment that has been developed to target Alzheimer’s. A pharmaceutical company in Singapore, TauRx, has developed a drug called LMTX. However, in a recent trial, only the patients with mild Alzheimer’s who were not taking other Alzheimer’s medication (around 15%) saw a moderate improvement.

Another drug, Solanezumab, is also undergoing a larger clinical trial. The results of this trial should be available by the end of the year. Like Aducanumab, Solanezumab works by attacking the build up of amyloid beta protein in the brain. Previous trials have been unsuccessful.

A further treatment, the ‘Bredesen Protocol’, involves no drugs at all. This is, in fact, a programme of lifestyle changes which include exercise, better sleep and nutritional supplements. Early evidence suggests it has helped around 100 patients who have been treated, but some scientists have labelled the evidence “anecdotal” and “patchy”. A clinical pre trial has been planned for Britain and the US.

All of the treatments so far appear to make a difference for patients in the early stages of the disease with only mild symptoms. This will make early detection of the disease more important than ever, going forward.

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