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Thursday, September 1, 2016

Alzheimer's: New drug that halts mental decline is 'best news for dementia in 25 years'

Sept. 1, 2016

Patients treated with the highest dose of aducanumab saw an almost complete clearance of the amyloid plaques which prevent brain cells communicating
The first drug that can prevent Alzheimer’s disease is finally on the horizon after scientists proved they can clear the sticky plaques from the brain which cause dementia and halt mental decline.
Hailed as the "best news" in dementia research for 25 years, the breakthrough is said to be a potential "game changer" for people with Alzheimer’s.
Scientists said they were amazed to find that patients treated with the highest dose of the antibody drug aducanumab experienced an almost complete clearance of the amyloid plaques that prevent brain cells communicating, leading to irreversible memory loss and cognitive decline.
Crucially they also found that after six months of the treatment, patients stopped deteriorating compared with those taking a placebo, suggesting that their dementia had been halted.
These findings could be a 'game changer' if the effects on memory decline can be confirmed in more extensive follow-on studies
David Allsop, Professor of Neuroscience, University of Lancaster
If shown to be effective in larger trials, the first drug to prevent dementia could be available in just a few years.
"The results of this clinical study make us optimistic that we can potentially make a great step forward in treating Alzheimer's disease," said Prof Roger Nitsch, at the Institute for Regenerative Medicine at the University of Zurich.
“In the high dose group the amyloid has almost completely disappeared. The effect size of this drug is unprecedented.
“Despite it being a small sample there appeared to be a slowing of cognitive decline and functional decline. The group with a high degree of amyloid removal were basically stable.  If we could reproduce this  it would be terrific.”

The red marks show amyloid plaques but after a year they are gone in the highest dose group

Dr Alfred Sandrock, from the Massachusetts-based biotech company Biogen, which is hoping to bring the drug to market, said: “This is the best news that we have had in our 25 years and it brings new hope to patients with this disease.”
There are currently 850,000 people living with dementia in Britain, a figure that is expected to rise to one million by 2025 and two million by 2050. The most common kind of dementia is Alzheimer’s disease, but scientists have been unable to reach consensus about the cause of the condition, and despite more than 400 drug trials, nothing has been shown to combat disease.
The last Alzheimer's drug licensed in the UK became available more than a decade ago. Current treatments can reduce symptoms to some extent but doctors have nothing that can halt or slow progression of the disease.
Not only does the new study suggest a treatment for the disease, but shows that the build-up of amyloid plaque in the brain is likely to be to blame.
Aducanumab is a treatment made up of antibodies,  tiny y-shaped proteins that latch on to dangerous substances in the body, acting like flags, showing the immune system what to clear away.
Scientists tested various human immune cells with amyloid in a laboratory until they found one which produced an antibody that broke up the plaques. They then cloned it in large numbers for the new therapy, which is given intravenously just once a month.

There are now two large phase-three clinical studies taking place to further evaluate safety and efficacy on a total of 2,700 patients with early-stage Alzheimer's disease and researchers are currently recruiting British participants.
"These results provide tantalising evidence that a new class of drug to treat the disease may be on the horizon,” said Dr David Reynolds, chief scientific officer at Alzheimer's Research UK.
"The findings suggest that aducanumab may slow memory and thinking decline in people with early Alzheimer's and, although the analysis is only exploratory in this early trial, it paints a positive picture for ongoing trials with the drug."

Although some people on the trial experienced side effects such as headaches, scientists believe that adjusting the dose may alleviate problems.
More than 800,000 people in Britain suffer from dementia, and the majority have Alzheimer's disease CREDIT: ALAMY
Prof David Allsop, Professor of Neuroscience, University of Lancaster, said: “This study shows convincingly that it is possible to reduce the extent of amyloid plaque formation in the brains of people with very early signs of dementia.
Encouragingly, this treatment also appeared to slow memory decline, demonstrating that amyloid formation is a direct or indirect cause of memory loss. This has been suspected for some time, but has never been proven in humans.
“These findings could be a game changer if the effects on memory decline can be confirmed in more extensive follow-on studies.”
The Alzheimer's Society said the "most compelling" evidence from the trial was the fact that more amyloid was cleared when patients took higher doses of the drug.
Dr James Pickett, head of research at the charity, said: "No existing treatments for Alzheimer's directly interfere with the disease process, and so a drug that actually slows the progress of the disease by clearing amyloid would be a significant step.
"While there were hints that it might have an effect on the symptoms of the disease, we need to see the results from further, larger research trials to understand whether this is the case. These larger trials are now under way, including in the UK, and due to finish in 2020."
Prof Richard Morris, Professor of Neuroscience at the University of Edinburgh, said: “We cannot yet say we have a cure for Alzheimer's, as this is only a first step … but the importance of this first step cannot be understated.
“Let’s keep our fingers crossed for success in the next steps.”

http://www.telegraph.co.uk/science/2016/09/01/alzheimers-new-drug-that-halts-mental-decline-is-best-news-for-d/

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