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updated: 12/14/2012 1:27 PM

Alzheimer's research proves disappointing

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By Gary Rotstein
Pittsburgh Post-Gazette

It has been a frustrating year -- a depressing decade, in fact -- for people hoping for breakthroughs in Alzheimer's research and treatment.

Two pharmaceutical giants invested hundreds of millions of dollars in an intravenous drug treatment known as Bapineuzumab, which was supposed to reverse the symptoms of Alzheimer's by erasing amyloid plaque that clogs the brain as one possible telltale sign of the disease.

Pfizer and Johnson & Johnson announced in August that they were discontinuing work on the drug as a failure, after study participants got their hopes up that they were assisting in an overdue advance in battling a global increase in dementia.

The research and advocacy community then placed its hopes on Solanezumab, an alternative amyloid-fighting drug from Eli Lilly & Co. In separate announcements in September and October, the company stated that its extensive trial did not produce the desired overall effects, but it did offer some potential for slowed cognitive decline among those with the mildest form of Alzheimer's.

It has been a long time, though, since anyone has been able to claim success in the Alzheimer's-treatment field, and even then the term "success" is best used with caution.

When the federal Food and Drug Administration approved use of Namenda to counter symptoms of the disease in 2003, it became the fifth and most recent drug marketed for the purpose. Whether it's Namenda, Aricept, Exelon, Razadyne or Cognex, however, the drugs work with variable effectiveness in different individuals and do nothing at all for some. The claims are only that in some cases they can address some of the symptoms, not that they can prevent or reverse Alzheimer's.

"Everybody, patients and physicians alike, had a great deal of hope" for Bapineuzumab, said Oscar Lopez, a neurologist who is co-director of the University of Pittsburgh's Alzheimer Disease Research Center. "We were very disappointed with the results."

Other drug trials remain in the pipeline at various stages, though Bapineuzumab and Solanezumab had jointly garnered the most optimism. When neither reached its goals, it was cause for more despair. Alzheimer's is the sixth-leading cause of death in America, and the Alzheimer's Association calls it the only one of the top 10 "without a way to prevent, cure or even slow its progression."

"Exactly how far away we are from knowing we have a treatment that will actually move us to one of these prevention schemes may or may not be years away," said William Thies, chief medical and science officer.

Dr. William Klunk, a psychiatrist who is co-director of the Alzheimer Disease Research Center, said that in the research field "many of us have already come to the conclusion that if you wait until Alzheimer's is clinically diagnosed, you've waited too long" to have any hope of attacking the disease. The future work on Solanezumab and the additional national studies getting under way could provide a path of hope someday for those in early stages, although expectations in the field have widely been tempered of late.

"It's an interesting time, but a tenuous time and scary time," Klunk said. "The fight's not over yet, but we've had 10 years now of drug-trial failure since Namenda was approved. ... We'd hoped for a better signal by now."

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