With a cure for Alzheimer’s still proving to be some way off, pharma companies and collaborators have increasingly been seeking new ways to detect early warning signs of the disease.
Research into treatments for Alzheimer’s has become disappointingly predictable, with trials and candidates in the area regularly abandoned following underwhelming results.
Yet the effort to find different ways to combat the neurodegenerative disease have not stalled, with researchers looking into the possibility of early detection as a new avenue to explore in the fight against Alzheimer’s.
Digital detection
One such promising study comes from Eli Lilly, in partnership with Apple and Evidation Health. This novel study showed that using a range of Apple’s digital devices in combination with digital applications could help to differentiate people with mild cognitive impairment (MCI), mild Alzheimer’s disease, dementia and those without symptoms.
The 12-week study evaluated 113 participants aged between 60-75 in real-world settings and analysed their use of the digital devices. The data obtained in this study was able to differentiate between individuals with or without cognitive impairment in ways that have not previously been possible through standard clinical screening tools.
By using data collected from wearable devices, researchers found that identifying when people begin to experience symptoms of cognitive decline could begin earlier than ever.
According to Divakar Ramakrishnan, Lilly’s chief digital officer, the findings from this study “could inform subsequent research that may eventually lead to early screening or detection tools for neurodegenerative conditions”.
Although it is still in its very early stages, the study is promising, with the potential to help detect the disease early and help to treat those who could be affected by Alzheimer’s and similar conditions.
In the pipeline: a blood test for Alzheimer’s
Another significant new area of research is the development of an early Alzheimer’s detection blood test, conducted by researchers from the Washington University School of Medicine in the US. According to researchers, a novel blood test developed in the study can accurately identify if a person is likely to develop Alzheimer’s before symptoms occur.
The test works by identifying amyloid-beta (Abeta) proteins, which build up on the brains of those living with Alzheimer’s and which have a key link to the disease, although it is not well understood.
According to the study, the blood test is able to identify this protein 20 years before the symptoms of the disease start to present. Not only can it predict Alzheimer’s early, but the blood test is possibly more effective than the current standard of detection, a PET brain scan, according to the researchers.
A string of failures
Historically, the research into Alzheimer’s therapeutics has focused on the link between Abeta proteins and the disease, but programmes hoping to target this area have continually failed. Pharma companies have gone on to blame the complexity of treating Alzheimer’s for these failures and have called for more research into the root causes.
Earlier this year, Amgen, Novartis and Banner Alzheimer’s Institute abandoned a research trial of an Alzheimer’s candidate after some participants taking the drug deteriorated faster than those on the placebo arm of the trial.
Biogen and Eisai also pulled the plug on their Alzheimer’s drug aducanumab, after advice from an independent data monitoring committee forced them to abandon the phase 3 Abeta-targeting candidate. It was just another in a string of late-stage failures in Alzheimer’s drug research.
Alzheimer’s R&D has had to diversify as companies and researchers become increasingly aware that the disease has a myriad of causes, which evolve with disease progression. Many are now coming to the same conclusion: that a combination of different therapies and detection methods could be the answer to fighting Alzheimer’s.
Forward thinking
Researchers are now looking to other causes of Alzheimer’s outside Abeta proteins, with more focus on other possible links, including a protein called tau, which is now thought to cause more damage to the brain than Abeta.
Alzheimer’s Research UK is launching head first into the fight, with a new drive towards therapies that avoid the Abeta route. According to the charity, the protein “may play its part so early in the disease process that by the time symptoms start to show and people can be recruited into trials, other damaging brain changes have already been set into motion”.
A new company has been created from Alzheimer’s Research UK’s Drug Discovery Alliance, which will build on the work of the charity’s UCL Drug Discovery Institute. This newly formed biotech company, named AstronauTx, has recently received £6.5m from the Dementia Drug Discovery Fund (DDF).
According to the charity, AstronauTx was formed to develop new medicines for Alzheimer’s which focus on resetting the behaviour of astrocytes, the crucial support cells in the brain.
What is clear is that researchers are still unsure as to what the definitive cause of Alzheimer’s is, with this fact reflected in the current treatments. But with such a wealth of promising research, and hefty investments across the board, there is optimism that effective treatments and detection methods for the disease are on the horizon.