What Research is Ongoing?
Currently, there are five FDA-approved drugs that treat the symptoms of Alzheimer's - temporarily helping memory and thinking problems in half of the people who take them.
In contrast, many of the new drugs in development aim to modify the disease process itself. Many researchers believe successful treatment will eventually involve a "cocktail" of medications aimed at several targets, similar to current treatment for cancer and AIDS.
Beta-amyloid is a protein that is the chief component of the plaques that are one hallmark of Alzheimer's disease. Solanezumab is an antibody designed to lower the level of beta-amyloid in the brain. These antibodies bind to beta-amyloid thus preventing the formation of plaques. Solanezumab may also help carry away the excess beta-amyloid. Several studies are under way with the goal of determining if the drug will improve patient's memory and thinking.
MK-8931 is an inhibitor of beta-secrease (an enzyme) to make beta-amyloid. This is currently being tested in two phase 3 clinical trials.
Tau protein is the chief component of tangles, the other hallmark of brain abnormality in Alzheimer's. AADvac1 is a vaccine that stimulates the body's immune system to attack an abnormal form of tau protein. If successful, it has the potential to stop the progression of Alzheimer's disease. This is currently in phase 1 clinical trials.
Inflammation is another key Alzheimer's brain abnormality. Both plaques and tangles can cause and immune response in the brain. CSP-1103 is a modulator that aims to reduce inflammation in the brain. Preliminary data is promising.
For reasons not completely understood, the brain becomes resistant to the normal effects of insulin. This is called insulin resistance. Intranasal insulin is being tested for its effects in memory, thinking, and daily functioning in people with early Alzheimer disease. This is early in the research stage.
The A4 trial (Anit-Amyloid Treatment in Asymptomatic Alzheimer's Disease) is studying the effects of solanezumab in symptom-free volunteers whose PET scans show abnormally high levels of beta-amyloid in the brain to determine if the disease can be prevented.
The TOMMORROW Trial includes 3,500 asymptomatic individuals, some of whom have the Alzheimer risk gene (APOE-e4). The trial is exploring whether the diabetic drug pioglitazone may decrease inflammation and beta-amyloid.
Dominantly Inherited Alzheimer Network Trial Unit (DIAN TU) Mutations on three genes are known to cause a rare form of Alzheimer's disease. Individuals who develop one of these mutations have virtually a 100% chance of developing the disease. Researchers are studying those patients who have not yet developed symptoms and studying the effects of both solanezumab and gantenerumab.
The Alzheimer's Prevention Initiative (API) is also studying people who have the gene mutation, but have not yet developed symptoms. Specifically, they are studying the effects of crenezumab, an immune-based therapy.
For patients interested in learning more about clinical trials or enrolling in clinical trials, we can make appropriate referrals to major research centers.