Hints of drug that can slow Alzheimer’s

The first hints a drug can slow the progression of Alzheimer’s disease have emerged at a conference.

Data from pharmaceutical company Eli Lilly suggests its solanezumab drug can cut the rate of the dementia’s progression by about a third.

The results are being met with cautious optimism, with a separate trial due to report next year.

The death of brain cells in Alzheimer’s is currently inexorable. Solanezumab may be able to keep them alive.

Current medication, such as Aricept, can only manage the symptoms of dementia by helping the dying brain cells function.

But solanezumab attacks the deformed proteins, called amyloid, that build up in the brain during Alzheimer’s.

It is thought the formation of sticky plaques of amyloid between nerve cells leads to damage and eventually brain cell death.

Silver lining

Solanezumab has long been the great hope of dementia research, yet an 18-month trial of the drug seemingly ended in failure in 2012.

But when Eli Lilly looked more closely at the data, there were hints it could be working for patients in the earliest stages of the disease.

So the company asked just over 1,000 of the patients in the original trial with mild Alzheimer’s to take the drug for another two years.

And the results from this extension of the original trial have now been presented, at the Alzheimer’s Association International Conference.

Dr Eric Siemers, from the Lilly Research Laboratories, in Indiana, told the BBC: “It’s another piece of evidence that solanezumab does have an effect on the underlying disease pathology.

“We think there is a chance that solanezumab will be the first disease-modifying medication to be available.”

The company also started a completely separate trial in mild patients in 2012, and these results could prove to be the definitive moment for the drug.

Potential breakthrough

Dr Eric Karran, the director of research at Alzheimer’s Research UK, told the BBC News website: “If this gets replicated, then I think this is a real breakthrough in Alzheimer’s research.

“Then, for the first time, the medical community can say we can slow Alzheimer’s, which is an incredible step forward.

“These data need replicating, this is not proof, but what you can say is it is entirely consistent with a disease-modifying effect.

“We’ve never ever had evidence that we can affect the disease process.”

Clare Walton, the research manager at the Alzheimer’s Society, told the BBC: “The data hints that the antibodies are having an effect, it is promising and it’s better than no effect, but it’s inconclusive.

“After a decade of no treatments and many drug failures, it’s exciting to get promising news, but it doesn’t really tell us either way, and we need to wait for the phase-three study, and that is in 18 months.”

How much benefit?

In the first stage of the original trial, which ended in failure, half of the patients with Alzheimer’s were given solanezumab and half were not.

A reanalysis of the cognition scores of the patients with mild Alzheimer’s suggested taking the drug had cut the rate of the disease’s progression by about 34%.

The implication is that the amount of cognitive decline normally seen in 18 months would take 24 months with the drug.

In the extension of the original trial, all of the 1,000-plus mild Alzheimer’s patients participating were given solanezumab.

So half of them have now taken the drug for three and a half years while the other half has taken it for two years.

The latest data suggests those taking solanezumab for the longest time still had better results.

This suggests that the course of the disease is being slowed.

If the brains of patients had continued to decline at the normal pace and the drug was merely helping with symptoms, then everyone would have similar scores of cognitive function.

BBC