July 30, 2008
New Alzheimer’s Drug Brings Hope to Millions
By Lyndsay Moss
A NEW drug capable of halting Alzheimer's disease in its tracks was hailed yesterday as a "hugely exciting" development in the battle against the devastating condition.
Those given the drug in the ongoing trials, which have been running for 19 months, experienced no significant decline in their mental function.
It is thought that the drug - called rember - could be at least twice as effective in treating the disease as current medicines.
The results of clinical trials on 321 people - including 96 from the north-east of Scotland - were unveiled at a major conference in the United States.
Experts hope the drug, expected to be widely available within four years, could initially be used in the earliest stages of Alzheimer's to stop the disease progressing. However, in the longer term, people could be screened for signs of Alzheimer's before symptoms even start, meaning they can begin preventive treatment before problems set in.
The discovery offers hope to millions of patients around the world struck down by Alzheimer's. It could also help the National Health Service as it faces a growing bill for treating the country's ageing population, with forecasts of soaring rates of Alzheimer's in future.
Rember has been developed by a team at Aberdeen University, led by Professor Claude Wischik. Working with the university's spin-off company, TauRx Therapeutics, based in Singapore, the team developed a drug to target the tangles that form in the brain of Alzheimer's sufferers.
It is the first drug to act on these tangles, which cause memory loss and dementia.
The tangles are made up of a protein called tau, which forms inside nerve cells. They first destroy the nerve cells linked to memory and then destroy neurons in other parts of the brain as the disease progresses.
The study, presented at the International Conference on Alzheimer's disease in Chicago, focused on 321 people with mild and moderate Alzheimer's disease. They were divided into four groups, three taking different doses of rember and a fourth group taking a placebo.
At 24 weeks, experts found there were significant differences between the groups in relation to people with moderate Alzheimer's. However, after 50 weeks, those with both mild and moderate Alzheimer's who were taking rember experienced an 81 per cent reduction in mental decline compared with those on the placebo.
Those on rember have not experienced a significant decline in mental function for the 19 months the trial has been ongoing, but those in the placebo group have got gradually worse.
Brain scans showed the drug had its biggest effect in those parts of the brain linked to memory, where the density of tau tangles is the greatest.
The drug works by dissolving the tau fibres and prevents a build- up of tangles. Larger Phase 3 trials are set to start next year, and the drug could be licensed by 2012.
The death of brain cells due to tangles can start over the age of 50, so early treatment could mean they can be caught before symptoms develop.
Prof Wischik said the results had been "unprecedented" in the treatment of Alzheimer's.
He added: "We have demonstrated for the first time that it may be possible to arrest progression of the disease by targeting the tangles, which are highly correlated with the disease. This is the most significant development in the treatment of the tangles since Alois Alzheimer discovered them in 1907."
Professor Stephen Logan, Aberdeen University's senior vice- principal, said the results were "hugely exciting".
He said the drug would initially be most useful in treating those in the early stages of Alzheimer's. However, he added the university was also working on developing a test to reveal the tangles in the brain long before symptoms start. No such test currently exists.
"It may be you use a scan, such as a PET [positron emission tomography] scan, to identify the tau tangles and start treatment before someone even knows they have Alzheimer's," he said.
Such a test could be used on people with a family history of dementia, but in decades to come may form part of an Alzheimer's screening programme for the whole population.
Prof Logan said it was not yet known how much the drug would cost - concern about the cost-effectiveness of current Alzheimer's treatments has seen campaigners take their cases to the High Court to press for increased access for patients.
Treatments, which include donepezil and rivastigmine, were initially recommended by health watchdogs for use in patients at all stages of the disease.
But in 2006, the National Institute for Health and Clinical Excellence (NICE) stated the drugs should only be prescribed to people with moderate-stage disease. The body said the drugs, which cost about GBP 2.50 a day per patient, did not make enough of a difference to recommend them for all patients and were not good value for money.
This has made the search for new treatments with a definite positive impact on patients all the more urgent.
Professor Clive Ballard, head of research at the Alzheimer's Society, said: "This
is the first realistic evidence that a new drug can improve cognition in people with Alzheimer's, by targeting the proteins tangles that cause brain-cell death."
Rebecca Wood, chief executive of the Alzheimer's Research Trust, said the results were "encouraging" and called for more human trials to assess side-effects.
About 700,000 people in the UK suffer from dementia. More than half have Alzheimer's.
Case Studies: Drug brings sufferers new confidence, positive outlook and 'levelled' concentration
WHEN Sandra Sutherland started to struggle to stay focused at work, her thoughts did not immediately turn to Alzheimer's disease.
But in 2005, while being investigated for another medical condition, she was diagnosed with the disease.
The 61-year-old, who lives with her husband and two sons in Aberdeen, said she was surprised to discover she had Alzheimer's.
She said: "I was gobsmacked. I tell everyone I have Alzheimer's and they can't believe it."
Mrs Sutherland, whose hobbies include doing crosswords and gardening, was lucky enough to start on the trials of the new drug, rember, two years ago and she believes that the medication has really helped her.
"Since I've been on the trial I feel more confident, more positive," she said. "I think my concentration has levelled off and not got worse."
Her husband, Ian, said: "Sandra still has days when she is not great, but there has been no decline in the mini mental tests she has had to do as part of the trial, so it would appear the medication is working."
Jimmy Hardie, 72, used mistakenly to put sugar in the fridge and suffer mood swings.
He and his wife, Dorothy, a 69-year-old former nurse, live in the coastal village of Boddam, south of Peterhead, Aberdeenshire.
He was diagnosed with Alzheimer's in 2005, after he suffered "blanks" and could not remember what he was about to do.
He started on the rember trial in 2006.
Mrs Hardie said the treatment had helped her husband to regain confidence, allowing him to continue running a trout fishery and enjoying DIY.
Mr Hardie, who worked at the nearby power station for 14 years, said: "I feel the treatment has helped me. Having a lot of friends and hobbies has also been a great help."
Another patient to have benefited from rember is Helen Carle, a grandmother of five who was diagnosed with Alzheimer's disease in 2003 after becoming forgetful and panicky. Mrs Carle, 68, was so anxious she did not like letting her husband, George, out of her sight.
The couple live in Cove, south of Aberdeen, and believe Mrs Carle's trial on rember, which she began taking three years ago, has helped to improve her mental state.
"I am still forgetful sometimes, but who isn't?" said the former department store assistant.
GBP 1.5 billion-GBP 1.7 billion
Cost of dementia in Scotland in 2007
Number of people with dementia in Scotland
people with dementia in Scotland under the age of 65
Predicted number of people with dementia in Scotland in 2031
GBP 2.6 billion-GBP 2.9 billion
Predicted cost of dementia in Scotland in 2031
75 per cent
Expected rise in dementia by 2031
People in the UK who have dementia
28 per cent
Proportion of people with dementia who have the most severe form
Number of people worldwide who will be aged 65 and over by 2050
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