Arjun Masurkar, MD, PhD: New Treatment on the Horizon for Alzheimer Disease
November 26, 2019
While there have been some major advancements in the last 10 years to help patients manage the symptoms attributed to Alzheimer disease, there has been an elevated push recently to find treatments that can ultimately slow the progression of the disease.
In an interview with MD Magazine®, Arjun Masurkar, MD, PhD, a neurologist and assistant professor in the departments of neurology and neuroscience & psychology at NYU Langone Health, explained why there is some hope finding new treatments for Alzheimer disease.
MD Mag: What drugs are on the horizon to treat Alzheimer disease?
Masurkar: And just to review, the medications that we have right now for Alzheimer’s disease are really for symptoms, treating the symptoms of memory and they've been around for about 15 to 20-years.
They include the cholinesterase inhibitors, donepezil and its 2 sister medications and memantine, which is an NMDA receptor antagonist. Those medications are not disease modifying.
They don't slow down the actual disease. They basically mask the symptoms of memory and so there's been a big quest to find medicines that actually slow the disease down for a while.
And the prime target for these trials has been amyloid. So, Alzheimer’s disease is defined by 2 abnormal proteins, amyloid and tau. By and large most trials have targeted amyloid.
One method has been antibodies to remove amyloid from the brain and there have been newer methods to try to reduce its production in the brain.
MD Mag: Are there any particular advancements that you can point to as the most significant in progression research or treatment of Alzheimer disease?
Masurkar: So overall our approachto the trials themselves havegreatly advanced. In the beginning inthis field we were recruiting people atthe very advanced stages.
We weren't sureif they really had Alzheimer's diseaseor not. With the advent of in vivoimaging of amyloid, as well as a focus onthe very earliest stages of the diseaseI think we're getting a betterhandle on what time points we can reallytake advantage and manipulate the courseof disease.
So recently there's been somenews about some positive signal and aclinical trial related to an anti-amyloid antibody. This is the Biogenstudy and what they found was that aparticular anti-amyloid antibody, aducanumab, slowed down both cognitivedecline and functional decline by about 15-to-20 percent over the course of about 70 odd weeks.
This evidence was from 1 version of the trial and in another trial, it didn't seem to have a statistically significant effect.
Either way they are moving forward with an application to the FDA for approval. But this is very exciting to all of us. We haven't been privy to the data itself, it needs to be vetted by the scientific community as well as the FDA, but either way I think that this lets us know that we are headed in the right direction and that amyloid may actually be a viable target.
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