Promising new Alzheimer’s drug aducanumab
There’s hope that the first true cure for Alzheimer’s disease is around the corner. In tests of patients with the disease, a new experimental drug removed plaque from their brains—amyloidal plaque—thought by many to be the underlying cause of the disease.
This was a huge first. No previous drug, ever, had removed that plaque.
Caution: hope ahead
Dr. David Reynolds, Chief Scientific Officer at Alzheimer’s Research UK, said “These results provide tantalizing evidence that a new class of drug to treat the disease may be on the horizon.”
The world is hoping. But hope can be cruel. The horizon has a way of staying very far away. This is a wonderfully promising beginning, but only a first step down a road littered with disappointing failures.
The trial study making news today monitored reactions to different doses of the drug for unwanted adverse reactions.
It will take years of further testing to reach the horizon…if we get there at all.
What’s aducanumab?
The new drug, called aducanumab, removed the build-up of the protein amyloid in the brain, and slowed decline in memory and thinking skills.
Sounds promising so far. Especially as we have only a limited arsenal of powerful prescription meds available to treat Alzheimer’s devastating symptoms. All of them are served with a numerous side effects, from disruptive and annoying, like headaches, dizziness, and constipation, to disastrous, like kidney failure.
Only five meds to treat Alzheimer’s are FDA approved, four of which are ACE inhibitors—variants of essentially the same mechanism, and effective only in treating symptoms. And to underscore how difficult it’s been to crack the Alzheimer’s code, between 2003 and 2014, not a single new class of drug was approved by the FDA.
The new kid in town shines
Aducanumab is an antibody programmed to target amyloid, the protein that builds up in the brains of people with Alzheimer’s at an early stage in the disease process.
Several drugs have been designed to target this process, but none have yet succeeded at removing the protein and improving outcomes for patients in the final stages of clinical testing.
Over the course of a year, the researchers gave monthly injections of aducanumab to 165 people, at doses of 1, 3, 6, or 10 mg per kilogram of body weight. The subjects had mild Alzheimer’s or early memory problems, plus markers on brain scans for high levels of the amyloid protein. Participants had regular brain scans, blood tests, and thinking/memory tests throughout the year.
The results?
Breakthrough.
Aducanumab reduced the levels of amyloid in the brain on brain scans, with the highest 10 mg/kg dose having the greatest effect. The researchers also found that aducanumab slowed the rate of decline in thinking/memory skills—the higher the dose, the greater the improvement.
Though there were predictable tolerance issues, aducanumab was considered safe enough for continued clinical development.
An international research team is working to better understand the side effects and how to prevent them. Additional clinical testing, on larger groups of participants, is underway.
Here’s hoping.
The old kids in town don’t shine
For people with Alzheimer’s and their caregivers, life is terribly difficult. Current drugs, as I mentioned, do nothing to heal the disease. They can only slow the progression of symptoms…which get worse over time.
Not a happy prognosis.
One common prescription med, Memantine, works as an NMDA receptor antagonist, which helps prevent or slow this destructive progression.
Side effects differ from one drug to the next, but can include:
- Hallucinations
- Lightheadedness
- Dizziness
- Fatigue
- Headache
- Out-of-body sensation
- Nightmares
- Sensory changes
The other four approved Alzheimer’s drugs all act as ACE inhibitors, which help relax blood vessels, keeping blood flowing where it’s needed. That’s a good outcome in almost every kind of treatment, especially when the health issue is cardiovascular. Good blood flow to the brain is also, of course, essential.
So the reasoning behind prescribing ACE inhibitors seems sound.
But wait.
As recently as 2014, a report in The American Journal of Geriatric Psychiatry said something rather alarming:
“The effect of…ACE inhibitors on Alzheimer (sic) disease (AD) remains unclear, with conflicting results reported.”
So why are ACE inhibitors so widely used, especially when possible side effects include:
- Dry cough
- Increased blood-potassium level (hyperkalemia)
- Fatigue
- Dizziness
- Headaches
- Loss of taste
- Potentially dangerous swelling
And especially when there are better, safer, natural alternatives?
While we hope aducanumab races toward the finish line, even though there’s no cure for Alzheimer’s, there’s a lot you can do to reduce the risk of developing it.
Researchers found five essential behaviors that protect against the disease:
- Exercising regularly
- A diet of nutritious, whole foods
- Maintaining a healthy weight
- Staying active mentally and socially
- Managing chronic ailments like depression, diabetes, and high blood pressure
The conclusion is clear and simple: Individuals who practiced all five lifestyle behaviors during the two years of the study had significantly higher scores on thinking/memory tests than those who did not.
A second study pinpointed additional anti-Alzheimer’s behaviors—not smoking and continuing to learn, to keep your mind active.
Experts are so confident that all of the behaviors here are effective, their estimates of lives saved from Alzheimer’s over time are in the millions.
I recommend daily walks totaling 40 minutes or so, preferably broken up in 2–3 shorter walks throughout the day.
I recommend omega-3 supplements: Since the brain is mostly made of fat, it makes sense to supplement with the most brain-friendly fat I know—omega-3 essential fatty acids (EFAs), especially one known as DHA (docosahexaenoic acid).
Research links a decreased risk of dementia with high levels of EFAs, and smaller brain volumes in individuals with low levels. In addition, the low-volume brains showed signs of cognitive impairment, even though they had not been diagnosed with dementia.
I recommend 1 gram of the EFAs, EPA and DHA, up to three times daily. Look for a sustainable product that’s had heavy metals and toxins filtered out.
I recommend 500 mg, 1–3 times daily, of a high-quality curcumin supplement, formulated for enhanced absorption or bioavailability.
A growing number of studies show that curcumin protects the brain against many age-related changes. And in cuisines around the world with high curcumin content, dementia rates are far lower than ours.
Never lose hope
With so many brilliant researchers worldwide working to make an Alzheimer’s cure a reality…it will happen.
Meanwhile, all it takes for excellent health is to take good care.
References
- “FAQ ClinicalTrials.gov – Clinical Trial Phases” NIH. Updated April 18, 2008. Last accessed February 27, 2017.
- “NMDA Receptor Antagonists and Alzheimer’s” WebMD. Reviewed August 15, 2016. Last accessed February 27, 2017.
- “Current Alzheimer’s Treatments” Alz.org. Published NA. Last accessed February 27, 2017.
- “Understanding Alzheimer’s Disease: Diagnosis & Treatment” WebMD. Reviewed February 11, 2017. Last accessed February 27, 2017.
- “Antibody clears Alzheimer’s protein from brain in clinical trial” Alzheimer’s Research UK. Published August 31, 2016. Last accessed February 27, 2017.
- Johnson,Ginger et al. “Aducanumab: Hype, or Headway for the Alzheimer’s Amyloid Hypothesis?” Defined Health. Published April 15, 2015. Last accessed February 27, 2017.
- Hamilton, Jon. “Test Of Experimental Alzheimer’s Drug Finds Progress Against Brain Plaques” NPR. Published August 31, 2016. Last accessed February 27, 2017.
- Sevigny, Jeff et al “The antibody aducanumab reduces Aβ plaques in Alzheimer’s disease” Nature 537, 50–56 (01 September 2016). Published August 31, 2016. Last accessed February 27, 2017.
- Robertson, Sally. “ACE Inhibitor Mechanisms” NewsMedical Life Sciences. Updated January 21, 2015. Last accessed February 27, 2017.
