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Alzheimer's Drug Shows Promise

Posted Mar 26 2010 2:35pm

Development of Drugs that Fight Cause of Alzhemier's is Key

Alzheimer’s disease is a brain disorder named for German physician Alois Alzheimer.   He first described the condition at a scientific meeting in November 1906.   There, he presented the case of “Frau Auguste D.,” a 51-year-old woman who was brought to see him in 1901 by her family. She had developed problems with memory, unfounded suspicions that her husband was unfaithful, and difficulty speaking and understanding what was said to her. Her symptoms rapidly grew worse.   Within a few years she was bedridden and died in Spring 1906.

Dr. Alzheimer had never before seen any patient like this.   He was able to gain the family’s permission to perform an autopsy. The pathological findings in the brain showed dramatic shrinkage, especially of the cortex, the outer layer involved in memory, thinking, judgment and speech. Microscopic inspection demonstrated widespread fatty deposits in small blood vessels, dead and dying brain cells, and abnormal deposits in and around cells.

The condition entered the medical literature in 1907, when Alzheimer published his observations about this case. In 1910, Emil Kraepelin, a psychiatrist noted for his work in naming and classifying brain disorders, proposed that the disease be named after Alzheimer.

Scientists have learned a great deal about Alzheimer’s disease in the century since Dr. Alzheimer first drew attention to it.

        * Alzheimer's disease facts:

        * Is a progressive and fatal brain disease.

        * Is the most common form of dementia.

        * Has no current cure.

        * Two abnormal structures called plaques and tangles are prime suspects in damaging and killing nerve cells

        * 5.3 million people have Alzheimer's

        * It is the 7th leading cause of death

        * Alzheimer's disease is responsible for an estimated $172 billion dollars in annual costs

        * There an estimated 10.9 million unpaid caregivers involved in dealing with family and friends with Alzheimer ‘s disease

The most significant new information coming from this year's report: African-Americans and Hispanics are at higher risk for developing Alzheimer's. African-Americans are about twice as likely to have Alzheimer's than whites, and Hispanics are about 1.5 times more likely than whites to develop the disease.   It is not clear why this is the case.   To date, no genetic issues can be implicated.   Relationships to high blood pressure and diabetes have been speculated to be present but that remains unproven.   The number of deaths attributed to Alzheimer's has been rising. From 2000-2006, Alzheimer's disease deaths increased 46.1 percent, while other selected causes of death decreased (stroke, -18.2%; prostate cancer, -8.7%; breast cancer, -2.6%; heart disease, -11.1%; HIV, -16.3%).   This trend is expected to continue, barring additional breakthroughs in medical treatment, as the baby boomers age.

New imaging technology suggests an experimental drug for Alzheimer's reduces clumps of plaque in the brain by around 25 percent, lifting hopes for a medicine that disappointed in clinical tests two years ago. Bapineuzumab -- being developed by Pfizer Inc (PFE.N), Irish drugmaker Elan Corp (ELN.I) and Johnson & Johnson (JNJ.N) -- is a potential game-changer because it could be the first drug to treat the underlying cause of the degenerative brain disease. Bapineuzumab is a humanized monoclonal antibody that acts on the nervous system and has potential therapeutic value for the treatment of Alzheimer's disease and possibly glaucoma. This drug is an antibody to the beta-amyloid (Aβ) plaques that are believed to underlie Alzheimer's disease neuropathology. In previous clinical trials for vaccination against human beta amyloid, called AN-1792, patients with Alzheimer's disease using active immunization had positive outcomes with removal of plaques.

Experts are divided on the root cause of Alzheimer's and hence the best way to tackle it. Most advanced drugs, like bapineuzumab, have focused on removing clumps of amyloid plaques, which are thought to stop brain cells from functioning properly. But a rival school blames toxic tangles caused by an abnormal build-up of the protein tau.

Currently, a number of drugs are used to treat symptoms of Alzheimer's disease.   In most cases, the early treatment in initiated the more symptoms can be moderated and controlled.   Progression can also be delayed, though not indefinitely.

Generic; Brand Name; Approved For; Side Effects

donepezil; Aricept; All stages; Nausea, vomiting, loss of appetite and increased frequency of bowel movements.

galantamine; Razadyne; Mild to moderate; Nausea, vomiting, loss of appetite and increased frequency of bowel movements.

memantine; Namenda; Moderate to severe; Headache, constipation, confusion and dizziness.

rivastigmine; Exelon; Mild to moderate; Nausea, vomiting, loss of appetite and increased frequency of bowel movements.

tacrine; Cognex; Mild to moderate; Possible liver damage, nausea, and vomiting.

To date we have learned much about Alzheimer's.   Clearly, we have much remaining to be learned.   Future advances will not only be an aid to patients with the disease, as well as their families and caregivers, but also to humans as a whole, since advances will require a far better understanding regarding the aging processes of the body in general, and the brain in particular.   We applaud this potential breakthrough and look for additional results from this trial.

Brain images suggest Alzheimer's drug is working -

What is Alzheimer's -

Bapineuzumab -

Monoclonal antibodies -

Alzheimer's Association -

2010 Alzheimer's Disease Facts and Figures -


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