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Behind the big dementia headlines of 2016: are we getting closer to a cure?

Dr Laura PhippsKirsty MaraisClaire LucasRobin BrisbourneKaty StubbsEd PinchesGlyn Morris

As we embark on a new year of dementia research, let’s take a look back to see how 2016 got us talking about dementia.

In Alzheimer’s diseases, there are two hallmark proteins that build up in the brain – amyloid and tau. Unsurprisingly, these two proteins have become the focus of drug discovery research in Alzheimer’s disease. And 2016 was a critical year for proving that one of these approaches might work. In this blog, we’ll explore what happened and how these stories made the headlines.

Solanezumab

Let’s start with the elephant in the room. Solanezumab is a drug that targets the hallmark Alzheimer’s protein amyloid. This protein can become sticky and clump together to form ‘plaques’ in the brain, and solanezumab was designed to target and remove the sticky amyloid before it clumped together. Initial results from an earlier trial looked promising, so the results from the most recent clinical trial were eagerly anticipated.

Why was it in the news?

The result from this trial were released in November and, sadly, they were not what we had hoped for. Due to the disappointing results, this drug is no longer at the forefront of the search for new treatments.

What next?

These results raised questions about whether this was the best way to target amyloid, or whether future drugs should be tested at an earlier stage in the disease. However, there are other promising studies endeavouring to answer these questions and bring us closer to finding a cure. The results from solanezumab – however undesirable – are helping to refine our knowledge about the limitations of the anti-amyloid approach and shape the ongoing search for new treatments. In January, Alzheimer’s Research UK hosted a round-table meeting of top global dementia experts to discuss the results and make sure we’re moving forward again in the right direction.

Aducanumab

Similar to solanezumab, aducanumab is a type of anti-amyloid antibody drug. The main difference is that solanezumab targeted amyloid before it formed plaques, whereas aducanumab is designed to remove plaques once they have formed in the brain.

Why was it in the news?

Last year, we heard about a study showing that aducanumab effectively cleared amyloid plaques from the brain in people. Fantastic, right? Well, maybe. This is a great start, but as with all medical research, we won’t know the full potential of this approach until we have the results of large clinical trials.

What next?

Next, we need to see whether this drug not only clears plaques from the brain, but also has a positive effect on the memory and thinking skills of people with dementia. A phase III clinical trial for aducanumab is currently underway, and has been recruiting participants with mild cognitive impairment (MCI) and mild Alzheimer’s disease using the research register Join Dementia Research. Results from this trial are expected in 2022 and if they are positive, it could lead to the first drug to be licensed for Alzheimer’s in over 14 years.

Verubecestat

Another drug tackling the build-up of amyloid in the brain, verubecestat aims to nip sticky amyloid in the bud before it has even been formed. It works by blocking the production of amyloid in the first place.

Why was it in the news?

In 2016, the results from an early-stage clinical trial showed that verubecestat reduced the amount of amyloid found in the fluid that surrounds the brain and spinal cord. Due to these positive results, two subsequent trials testing the drug in people at different stages of Alzheimer’s were started, however one has now been stopped.

How possible treatments are tested – Click to enlarge

What next?

For the trial that is still underway, we don’t have to wait long to hear the results. This study, due to end in 2019, is looking to see whether the drug can slow the decline in memory and thinking skills in in people at the earliest stages of the disease.

LMTM

LMTM is a drug based on a blue dye that is used in research laboratories across the world, and in surgical procedures as a stain. Researchers in Aberdeen hoped that this compound would block a second key dementia protein called tau from clumping together in the brain in diseases like Alzheimer’s and frontotemporal dementia.

Why was it in the news?

The majority of drug development research has focused on blocking amyloid, a hallmark Alzheimer’s protein. However, the results from LMTM were the first to be seen from of a phase III clinical trial of a drug aimed at blocking tau. Unfortunately, despite earlier positive suggestions, scrutiny of the research data showed that the drug did not slow decline in memory and thinking any more than placebo (or dummy treatment).

What next?

As tau is implicated in many forms of dementia, a successful tau-busting drug has the potential to change the landscape of dementia research. There are currently a handful of tau-targeting compounds in the very early stages of clinical trials, so it will be interesting to see how these pan out in the coming years.

Sea Hero Quest

In 2016, Alzheimer’s Research UK joined forces with Deutsche Telekom to launch Sea Hero Quest, a smartphone game where two minutes of play equates to five hours of dementia research. This fun game designed to help researchers learn more about our spatial navigation and has now had 2.4 million players, generating over 9,400 years’ worth of dementia research!

Why was this app in the news?

The researchers have recently released the first results from this study. These results have shed light on how our spatial navigation changes as we age, and now a new version of the game will be developed for use in a clinical setting.

What next?

By using the game with people with early dementia, and comparing their results to the population data they are working to generate, the team hopes to develop an early diagnostic test for diseases like Alzheimer’s.

What can we look forward to?

Next month Alzheimer’s Research UK is hosting our dementia research conference in Aberdeen, uniting researchers and encouraging collaborations. Look out for updates on our blog. Our blog will also be able to keep you up-to-date with AAIC – the world’s largest dementia research conference, which is coming to London this July.

Thanks to you, we funded 70% more projects in 2016 than the year before, and 2017 is set to be even better. In addition to this, some of our big initiatives are well underway. Our Drug Discovery Alliance is supporting the translation of cutting-edge academic science towards new treatments for dementia, and Prof Jane Armitage is now leading the first clinical trial to be funded through our Global Clinical Trials Fund. To help us fund more research like this, donate online today.

Get involved

To find out more about how you can volunteer for dementia research studies, read more about Join Dementia Research on our website. If you prefer, you can also call our Dementia Research Infoline on 0300 111 5 111.

8 Responses to Behind the big dementia headlines of 2016: are we getting closer to a cure?

  1. Avatar
    Geoff Belbin 28 February 2017 at 8:41 pm #

    Why no mention of Liraglutide. believe you are part funding a study under the auspices of Imperial College London

    • Avatar
      jackie Stuart 1 March 2017 at 8:35 am #

      I do some work for the British Legion and some people have dementia and they have told me nothing can be done to make it better. If there is something I can tell them please let me know

      • ARUK Blog Editor
        ARUK Blog Editor 1 March 2017 at 4:22 pm #

        Dear Jackie,

        Thank you for contacting Alzheimer’s Research UK.

        Unfortunately, there is currently no medication that can slow or stop the progression of Alzheimer’s disease, however there are some treatments that can help with day-to-day symptoms. If the gentlemen you are working with would like to find out more about these medications, then it would be best for them to discuss this with their doctors. You might also like to direct them to our website for more information about the treatments for dementia, where our information is presented online, can be downloaded as a PDF, or a paper copy can be ordered free of charge: http://www.alzheimersresearchuk.org/about-dementia/helpful-information/treatments-available/.

        They may also be interested to hear about Join Dementia Research, a nationwide service that enables people to register their interest in taking part in research. This service is designed to match people to appropriate research studies, and anyone, with or without dementia, can register their interest as a volunteer. The research studies available are happening all across the UK and can range from doing memory tests to having brain scans, or even taking part in drug trials. They can access this service online at http://www.joindementiaresearch.nihr.ac.uk/, or if they prefer, they can register over the telephone on 0300 111 5 111.

        Dementia Research Infoline

    • ARUK Blog Editor
      ARUK Blog Editor 3 March 2017 at 9:13 am #

      Dear Geoff,

      Thank you for contacting Alzheimer’s Research UK.

      In this blog, we tried to focus on the biggest dementia headlines of 2016. Although there was some data published about liraglutide in 2016, it was from a small study and, although it showed an impact of the drug on brain activity, it did not show any effect on memory. As you mentioned, there are other studies of liraglutide currently underway and we look forward to seeing the results of these when they come out. While we did fund some of the initial work looking into the potential of drugs like Liraglutide in Alzheimer’s disease, we’re not funding the trial at Imperial.

      ARUK Blog Editor

  2. Avatar
    Janusz Adamson 28 February 2017 at 8:59 pm #

    The Sunday Times (26 Feb) reported that “two decades of work had produced no effective therapies”, also “the field has been narrowly focused on amyloid for years but it has turned out to be the wrong idea so we need to look elsewhere”.

    Some thoughts

    An analogy about amyloids – the brain is initially like a new car engine. Clean engine oil helps the car run smoothly. Dirty oil, caused by accumulation of particulates ( a combustion engine produces particulates as it burns fuel), causes the engine to run less efficiently. If the oil is not changed, the particulates will eventually damage the engine.

    My mother (who passed away 2 years ago) had several forms of dementia, including early stage alzheimer, and I believe a visual variant of alzheimer. Part of the cause could have been due to higher levels of local and air-borne particulates, and stage 4 kidney failure.

    Could one of the new approaches to investigating alzheimer/dementia be to consider the brain to be an advanced biological computer and the blocking of neural networks be analogous to computer viruses interfering with computer performance. A computer scientist could look at re-routing networks to maintain performance.

    When a patient suffers an injury, the brain may need retraining to bring back the injured functionality. Alternatively a micro-electronic by-pass may be required to re-establish the damaged functionality.

    When analysing causes of alzheimer/dementia, analysts appear to look at “simple, i.e. one-to-one” correlations. Have analysts considered muli-variate analysis?

    Recent reports have suggested environmental links with dementia. Multi-variate analysis could look at the address of subject and consider distance from main road, urban/suburban/rural location, age of house (e.g. does it have lead/copper pipes, heating systems), various particulates, diet, toxin intake, medical conditions (e.g. CKD, parkinsons, MND, etc.), age, etc.

    An analogy – one of my MoD projects in the 1970s was to look at ship efficiency using multi-variate analysis. Various sensors were analysed to optimze sensor performance; the outcome was to identify which sensor/combination of sensors had the greatest impact.

  3. Avatar
    Vivian 1 March 2017 at 7:35 pm #

    Hi Adamson,
    you are right!
    Take a look at William Walsh’s web, the MT Therapy and his book “Nutrient Power”.
    Drugs that target the Amyloid tangles, will just wash the dirt but not stop the causes or regenerate anything in my view.
    I’m sorry for your mother, got my mum in similar condition in Brazil and am trying to convince the people in charge (she is in government care with a generous retirement pension) that there are better treatments than just being attached to a bed, pipe fed.
    I am currently presenting a research project at UEL for Alzheimers under guidance of a Brazilian Neuroscientist that I deeply respect.

    Will keep Dementia UK posted.

  4. Avatar
    House Manager 11 March 2017 at 11:19 am #

    Facinating so glad to hear these up dates thank you.

  5. Avatar
    Robert Deans 24 March 2017 at 11:49 am #

    I find everything a bit much at this stage in my diagnosis of Dementia. I failed a memory check and am now on DONEPESIL. I have had a month on 5 mgs, and have just started on 10 mgs (my first day) so far no side effects except for cramps.
    I am 80 years old and was a Medical Doctor.
    I am,therefore, interested in any information coming my way.
    Please contact me via my Email address at any time
    Regards
    Robert.

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