Hopes rise again for a drug to slow Alzheimer’s disease

CHICAGO — Hopes are rising again for a drug to alter the course of Alzheimer’s disease after decades of failures. An experimental therapy slowed mental decline by 30 percent in patients who got the highest dose in a mid-stage study, and it removed much of the sticky plaque gumming up their brains, the drug’s makers said Wednesday.

The results have been highly anticipated and have sent the stock of the two companies involved soaring in recent weeks.

The drug from Eisai and Biogen did not meet its main goal in a study of 856 participants, so overall, it was considered a flop. But company officials said that 161 people who got the highest dose every two weeks for 18 months did significantly better than 245 people who were given a dummy treatment.


There are lots of caveats about the work, which was led by company scientists rather than academic researchers and not reviewed by outside experts. The study also was too small to be definitive and the results need to be confirmed with more work, dementia experts said. But they welcomed any glimmer of success after multiple failures.

“We’re cautiously optimistic,” said Maria Carrillo, chief science officer of the Alzheimer’s Association, whose international conference in Chicago featured the results.

“A 30 percent slowing of decline is something I would want my family member to have,” and the drug’s ability to clear the brain plaques “looks pretty amazing,” she said.

About 50 million people worldwide have dementia, and Alzheimer’s is the most common type. There is no cure— current medicines just ease symptoms. Some previous efforts to develop a drug to slow the disease may have been tried too late, after much damage had already occurred. The new drug aimed sooner, in people with early Alzheimer’s, and the drug works at an earlier step in formation of the sticky brain plaques.

Study participants were given one of five doses of BAN2401 or a dummy treatment via IV. After one year, the companies said the drug didn’t meet statistical goals. But after 18 months, they saw a benefit in the highest dose group.

What makes it tricky, though, is that they used a new way to measure mental decline, a scale that combines parts of three other widely used tests. This is the first study to use that measure, and it’s unclear how much of a difference a 30 percent slowing of decline makes — whether it allows someone to continue to bathe or feed himself, for instance.

“It’s intriguing, but these are designs we’re not used to seeing,” and it will require more study for doctors to feel comfortable with this as a measure of success, said one independent expert, Dr. Julie Schneider of Rush University Medical Center in Chicago.

On one traditional measure of thinking skills, those at the highest dose declined 47 percent less than people given a dummy treatment.


Brain scans added evidence that the drug might be effective. All participants had signs of the sticky plaques that are the hallmark of Alzheimer’s at the start of the study, but 81 percent of people on the highest dose saw all signs of them disappear after 18 months, an Eisai official said.

Side effects leading to discontinuation of treatment occurred in 19 percent of those on the high dose and 6 percent of the dummy treatment group. Cases of brain swelling, which have been seen in other treatments targeting the plaques in the brain, occurred in two people in the placebo group and 16 of those in the high dose group.

Other dementia experts were encouraged.

“That’s a very hopeful outcome. It means we may be on the right track,” said another scientist with no role in the work, Dr. Stephen Salloway, neurology chief at Brown University in Providence, Rhode Island.

Dr. Reisa Sperling, a neurologist at Harvard-affiliated Brigham and Women’s Hospital in Boston, said it’s important to realize that this is not a cure, just possibly a slowing of decline.

“We’re not suddenly returning people back to their pre-Alzheimer’s baseline,” she said.

Dr. Lynn Kramer, chief medical officer of Eisai’s neurology unit, said the companies would talk with regulators about further studies.

Shares of Biogen, based in Cambridge, Massachusetts, and Eisai, based in Tokyo, soared after July 5 when they announced that the drug had slowed the progression of early Alzheimer’s disease for certain patients. Biogen’s stock jumped 19.6 percent in one day, its biggest move in 14 years, and has continued to rise. Eisai rocketed 40 percent in two days.

Biogen stock gyrated in aftermarket trading after the study results were released. After switching between gains and losses several times, it fell 6.5 percent.  /muf

source: technology.inquirer.net

Second language linked to better brain function after stroke

People who speak two languages are twice as likely as those who only speak one to regain normal cognitive function after a stroke, according to a new study.

In recent years it has become clear that life experiences modify the way disease expresses itself in the brain, said lead author Dr. Suvarna Alladi, a neurology professor at Nizam’s Institute of Medical Sciences in Hyderabad, India.

“One study in Toronto demonstrated that people who could speak two languages had later onset dementia,” Alladi told Reuters Health.

Using multiple languages challenges the brain, as it can be harder to find a particular word switching between languages, and this challenge promotes neuroplasticity or “cognitive reserve,” which prepares the brain to deal with new challenges, like disease, she said.

Researchers reviewed the medical records of 608 patients in the stroke registry at Alladi’s institution between 2006 and 2013. In Hyderabad, Telugu, Urdu, Hindi and English are all common languages and children learn three languages in school, Alladi said.

More than half of the stroke patients spoke at least two languages.

After accounting for other lifestyle factors like smoking, high blood pressure, diabetes, age and education, the researchers found that about 40 percent of those who were bilingual had normal cognitive function after a stroke, compared to 20 percent of those who spoke only one language.

Bilingual people also performed better on tests of attention after a stroke, but there was no difference in the likelihood of experiencing aphasia, or loss of ability to understand or express speech, according to the results in Stroke.

“They develop stroke at the same age but outcomes appear to be better for bilinguals,” Alladi said.

Using a second or third language regularly, or speaking it fluently even if you do not use it regularly, seems to provide the benefit to the brain, she said.

“The most important factor would be long-term language use,” she said. Learning a second language in school and then never using it may not confer the same benefit, she said.

“The take-home message would be that cognitively stimulating activities are something you can do in midlife to protect yourself. One is speaking two languages, but it could also be playing a musical instrument,” or other challenging activities, she said.

“This is heartening because you know that you can do something to protect yourself,” Alladi said.

Three languages may be better than two languages, though that is still unclear, “but I suspect the additional positive effects of further languages falls off quickly as more languages are learned,” said Fergus Craik of the Rotman Research Institute at Baycrest in Toronto, who was not part of the new study.

He and his colleagues previously found that bilingualism delays the onset of Alzheimer’s disease by four to five years.

“People should learn a second language to communicate in a second living situation or to absorb a different culture – or out of interest and enjoyment,” Craik told Reuters Health by email. “The neurological benefits are a bonus, not a primary goal.”

In many parts of the world, like India, Africa and Europe, speaking multiple languages is already common practice, Alladi said.

“In places where two languages are existing, it’s a good idea to encourage that,” she said. — Reuters

Want to know if you have Alzheimer's? Try some peanut butter

A-la peanut butter sandwiches! Just as The Amazing Mumford invokes peanut butter for his magic tricks, researchers at the University of Florida are now turning to the treat for detecting Alzheimer’s disease in its early stages.

Graduate student Jennifer Stamps thought of using peanut butter to test patients for their sense of smell, which could deteriorate with cognitive decline.

"One of the first places in the brain to degenerate in people with Alzheimer’s disease is the front part of the temporal lobe that evolved from the smell system, and this portion of the brain is involved in forming new memories," the university said in a news release.




Stamps and Dr. Kenneth Heilman, the James E. Rooks distinguished professor of neurology and health psychology in the UF College of Medicine’s department of neurology, said this test could be used by clinics that cannot run more elaborate tests.

The university added the peanut butter test will be one more added tool in an arsenal of clinical tests for neurological function in patients with memory disorders.

“We see people with all kinds of memory disorders. This can become an important part of the evaluation process,” Heilman said.

With her colleagues, Stamps, a graduate student in the UF McKnight Brain Institute Center for Smell and Taste, decided to test sensitivity with peanut butter and a ruler.

They reported the findings of a small pilot study in the Journal of the Neurological Sciences.

Stamps said she thought of peanut butter because it is a “pure odorant” that is only detected by the olfactory nerve and is easy to access.

Study details

In the study, patients who were coming to the clinic for testing sat down with a clinician with a tablespoon (14 grams) of peanut butter and a ruler.

The patient would close his or her eyes and mouth and block one nostril. The clinician then opened the peanut butter container and held the ruler next to the open nostril as the patient breathed.

The clinician would move the peanut butter up the ruler one centimeter at a time until the patient could detect an odor.

After recording the distance, the clinician would repeat the procedure on the other nostril after a 90-second delay.

In the study, the researchers found patients in the early stages of Alzheimer’s disease had a dramatic difference in detecting odor between the left and right nostril.

The left nostril turned out to be impaired and did not detect the smell until it was about 10 cm closer to the nose than the right nostril.

Patients with other kinds of dementia did not have such a degraded sense of smell, the university noted.

More studies needed

The researchers said more studies may be needed, after noting that of the 24 patients tested who had mild cognitive impairment, 10 showed a left nostril impairment and 14 patients did not.

“At the moment, we can use this test to confirm diagnosis. But we plan to study patients with mild cognitive impairment to see if this test might be used to predict which patients are going to get Alzheimer’s disease,” Stamps said. — TJD, GMA News

source: gmanetwork.com