The U.S. Food and Drug Administration (FDA) has granted approval to Zunveyl, a novel oral formulation of galantamine, for the treatment of cognitive symptoms associated with mild to moderate Alzheimer's disease. Developed by Alpha Cognition, Zunveyl represents the first new oral medication approved for Alzheimer's cognitive symptoms in over two decades and is anticipated to be available in pharmacies by 2025.
Zunveyl is a modified version of galantamine, a cholinesterase inhibitor commonly prescribed to manage cognitive symptoms in early to moderate stages of Alzheimer's. Cholinesterase inhibitors like Aricept and Razadyne are effective, but studies reveal that a significant proportion of patients discontinue use due to gastrointestinal side effects. Specifically, between two and three out of every five patients experience nausea, vomiting, or diarrhea.
Addressing Gastrointestinal Side Effects
To mitigate these issues, Alpha Cognition reformulated galantamine into Zunveyl (previously known as ALPHA-1062). This new formulation, benzgalantamine, is designed to bypass the gut, reducing the incidence of gastrointestinal side effects. The drug is packaged in a delayed-release capsule to minimize interaction with the gastrointestinal tract, potentially improving tolerability and adherence.
Lauren D’Angelo, Alpha Cognition’s chief operating officer, stated that Zunveyl offers dual-action benefits with the established efficacy of galantamine and no insomnia. She added that it was uniquely designed to bypass the gut with the potential of minimizing GI side effects, and the company believes that Zunveyl’s unique combination of these attributes will make a meaningful difference in the lives of those affected by this debilitating disease.
Mechanism of Action and Clinical Data
Zunveyl functions as a precursor to galantamine, which is activated upon metabolism in the body. The modified formulation is designed to allow more of the active drug to reach the brain, potentially enhancing its effectiveness in managing cognitive symptoms for a longer duration.
Clinical trial data published by Alpha Cognition demonstrated that less than 3% of patients taking Zunveyl experienced nausea, vomiting, or diarrhea over a seven-day period. This is significantly lower compared to the reported side effect profile of traditional galantamine, where 38% of patients experienced nausea or vomiting, and 9% experienced diarrhea.
Galantamine Background and Potential Benefits
Galantamine, derived from daffodil bulbs, works by slowing the breakdown of acetylcholinesterase, a crucial neurotransmitter involved in memory and cognitive functions. By inhibiting its breakdown, galantamine helps promote memory retention.
Furthermore, there is emerging evidence suggesting that galantamine may also slow the disease process itself. A 2021 study following over 10,000 patients on galantamine for ten years indicated a lower risk of death and a stronger effect on cognitive decline compared to other cholinesterase inhibitors. According to Michael McFadden, CEO of Alpha Cognition, galantamine also demonstrated a significant reduction in risk of developing severe dementia compared to other cholinesterase inhibitors.
Cost and Future Developments
The anticipated out-of-pocket cost for Zunveyl is projected to be between $30 to $50 per month. Alpha Cognition is also developing alternative formulations of Zunveyl, including a dissolvable tablet for patients with difficulty swallowing and a combination pill containing Zunveyl and memantine for treating symptoms in moderate to severe Alzheimer’s stages.
