The Clinical Trials on Alzheimer's Disease (CTAD) conference in Madrid showcased significant progress in developing next-generation drugs and early detection methods for Alzheimer's disease. The conference emphasized the need for diverse treatment approaches and highlighted promising advancements in diagnostic tools.
Next-Generation Alzheimer's Treatments
While the recent decisions regarding lecanemab and donanemab have been disappointing, they have paved the way for future Alzheimer's treatments. Researchers are actively developing safer and more effective drugs. A key challenge is delivering drugs across the blood-brain barrier. Roche's trontinemab utilizes a 'Brainshuttle' to facilitate drug transport from blood vessels to brain cells, potentially reducing the risk of ARIA (amyloid-related imaging abnormalities), including brain swelling and bleeding. Early-stage trials of trontinemab have shown promising results, indicating improved brain penetration and amyloid plaque clearance. However, further trials are needed to assess its efficacy and side effect profile.
Eli Lilly's remternetug, currently in late-stage clinical trials, is administered via injection, offering a potentially more practical and affordable alternative to lecanemab and donanemab. The results from the latest trials are expected next year.
Combination Therapies and Diverse Treatment Approaches
The Alzheimer's Drug Discovery Foundation (ADDF) emphasized the urgent need for a cure for dementia, advocating for diverse treatment options, including tailored combination therapies. Upcoming treatments include genetic therapies targeting Alzheimer's at its source and medicines targeting inflammation. Research is also focusing on medicines that remove tau protein and treatments that accelerate the brain's waste clearance processes.
Early Detection Methods
Blood tests, particularly those detecting p-tau217, have emerged as promising tools for early Alzheimer's detection. Several presentations at CTAD highlighted p-tau217 as the most accurate blood-based biomarker for Alzheimer's disease to date. These blood tests are being used in research laboratories and clinics to detect features of Alzheimer's with high accuracy. Prof Jonathan Schott highlighted the potential of these blood tests to improve the speed and accuracy of dementia diagnoses in memory clinics.
Researchers are also exploring the use of eye scans and speech patterns to assess an individual's risk of developing dementia.
Blood Tests Shaping Clinical Trials
Blood tests are playing an increasingly important role in clinical trial enrollment. The AHEAD 3-45 study, which is evaluating lecanemab's potential to slow or stop Alzheimer's disease before symptoms manifest, utilized blood test data from over 20,000 individuals to identify participants with high levels of amyloid in the brain. This approach could potentially save time and money by reducing the need for brain scans. Dr Ashvini Keshavan presented work on using blood tests measuring p-tau217 to predict who is unlikely to develop signs of Alzheimer's up to six years later, which is crucial for trials aiming to test the efficacy of new medicines in slowing or preventing the disease.
