Last month a report from 2015 stated these statistics:
“Between 1998 and 2014, there were 123 unsuccessful attempts to develop drugs to treat Alzheimer’s – or as some call them “failures.” In that time frame, four new medicines were approved to treat the symptoms of Alzheimer’s disease; for every research project that succeeded, about 30 failed to yield a new medicine.”
The group representing drug companies updated that report, with a report that said that there are 87 potential treatments in clinical trials.
Will any of them be successful? Why has it been so difficult to make headway into this disease?
We asked Dr. David Paydarfar, neurology chair at Dell Medical School, who is the lead investigator of a study on Alzheimer’s disease that is looking at people before they are diagnosed.
He has two theories:
1. We need to be intervening much sooner, way before anyone is diagnosed, to stop the disease from progressing.
2. There actually might not be one Alzheimer’s. There might be different kinds and the drug treatments that work for one might not work for all. The drugs we’ve been testing might actually have been effective but only for a subset of the disease.
Paydarfar says we need to get a better sense of what causes Alzheimer’s. He likens it to decades before when researchers thought that smoking was causing ulcers when actually it was bacteria.
“Research might be barking up the wrong tree,” he says. “Is there something that we’re missing?”
We also might be developing treatments that are one size fits all when really we need many different treatments for many different kinds of dementia.
Years ago, anyone with dementia was given an Alzheimer’s designation and then researchers started figuring out that in one kind of dementia that is now called vascular dementia people were actually having damage from a series of mini strokes. It wasn’t what we thought of as Alzheimer’s at all.
To make more breakthroughs in treatment of Alzheimer’s or what we’ve been calling Alzheimer’s, Paydarfar is looking at better predicting with certainty down to the exact person who will get the disease. He and other researchers are trying to find biomarkers. Knowing with certainty that a person is going to get Alzheimer’s will help scientists develop treatments that are preventative rather than restorative.
He’s also looking at improved imagery of the brain that will allow us to better track the progression of the disease as well as to better track the progress of treatments.
Paydarfar also wonders if the disease is not a reaction by the body’s immune system to an infection or inflammation. He points to people with vascular dementia who experience a worsening of symptoms every time they have a minor infection.
While there’s nothing coming down the pipe from drug developers that has gotten beyond stage two or stage three in trials, Paydarfar remains an optimist. In his career as a neurologist, he has seen remarkable strides made in the treatment of multiple sclerosis and in the treatment of strokes.
“I came into neurology at a time when there were very few treatments for any neurological diseases,” he says. He remembers hospitals with entire wards of people with MS. Now they are getting treatment at home, he says.
And in strokes, “prevention and treatment when it’s happening has just been breathtaking.”
He hopes for a substantial breakthrough in Alzheimer’s in the next five years. “I’ve seen it happen twice now,” he says. “With the right investment, leadership and talent, I feel very optimistic.”