Five Highlights from the Alzheimer’s Association International Conference

Five Highlights from the Alzheimer’s Association International Conference
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Alzheimer's Association

Last week in London, I joined advocates and the research community at the annual Alzheimer’s Association International Conference. This year’s conference didn’t offer much breaking news, instead focusing on steady progress in both treatment and prevention. I share my top five highlights from a productive week.

Prevention is Possible

Some of the most exciting research released during the conference was on dementia prevention. A report published in the Lancet, which I discussed with BBC World News, identified nine modifiable risk factors that account for up to a third of all dementia cases. Effectively addressing the nine risks—(1) less early-life education; mid-life (2) hearing loss, (3) obesity, and (4) hypertension; and later-life (5) smoking, (6) depression, (7) physical inactivity, (8) social isolation, (9) and diabetes—can significantly reduce your odds of developing Alzheimer’s disease, the most common type of dementia.

Diagnostic Tools Matter

More than a decade ago, the Alzheimer’s Drug Discovery Foundation (ADDF) provided funding to develop a PET scan for beta-amyloid plaques, which are found in the brains of patients with Alzheimer’s. The scan, now called Amyvid™, went on to become the first diagnostic test for Alzheimer’s approved by the FDA in 2012. The scan isn’t covered by most insurers, so it hasn’t been widely used. But interim results from the IDEAS study, which is using the PET scan, demonstrate its vast potential. The study enrolled over 18,000 people diagnosed and being treated for either mild cognitive impairment or dementia. Researchers found that only 54.3% of those diagnosed with mild cognitive impairment had amyloid plaques and only 70.5% of those diagnosed with dementia had them. As the study noted, the PET scans resulted in major changes to patient treatment and counseling. But accurate diagnoses are also critical for clinical trials of new drugs. Patients need to have the problem (such as amyloid) that the drugs being tested are designed to fix for a trial to have any chance of success.

Amyloid is Here to Stay

Though the list of anti-amyloid drug failures is growing, many potential Alzheimer’s drugs targeting beta-amyloid are still in development. Several companies—including Alzheon, Biogen, Eisai, Merck, and Lilly—shared data on their anti-amyloid drug programs in London. The good news is that the pharmaceutical industry remains committed to finding Alzheimer’s treatments. Less good is that much of their investment remains primarily focused on a single target, beta-amyloid, even though we know Alzheimer’s has many contributing factors.

Tau Therapeutics are Gaining

Though anti-amyloid drugs account for about 40% of all Alzheimer’s therapeutics in clinical trials, other targets are making inroads. At the conference, an increasing number of panels and meetings were focused on tau, including one session in the “Emerging Concepts” series. Like beta-amyloid, tau is a protein that misfolds, accumulates, and becomes toxic. In the brains of people with Alzheimer’s and frontotemporal dementia, tau forms the hallmark tangles. While most of the talks focused on tau’s role in dementia and ways to image it, there were discussions about some of anti-tau treatments now in clinical trials, including programs from Lilly, AbbVie, and AC Immune. All of these potential treatments use immunotherapy (rather than a typical drug), which is an expensive form of treatment. But they all also hold promise for treating both Alzheimer’s and frontotemporal dementia.

Combination Therapies Emerge

There were very few conference sessions on combination therapies, but I found a growing interest in them during private meetings with both researchers and funders. Combination therapies use two or more drugs targeting different causes of Alzheimer’s at the same time. Because Alzheimer’s is a complex disease, we will likely need more than one drug to effectively treat it. The ADDF held its first advisory meeting on combination therapy trials just two short years ago, and we are already seeing progress. Axovant presented data during the conference on its combination therapy trial, and the ADDF and Alzheimer’s Association are co-funding a combination therapy program and will announce the first grantee later this year.

While this year’s conference didn’t make as many splashy headlines, it did provide hope that dementia prevention and treatment is possible. I left London confident that we are making progress.

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