Another " Alzheimer’s breakthrough " has been widely reported in the UK this week :-

" Landmark drug to stop Alzheimer’s disease has been unveiled … Solanezumab has been shown to slow or even halt the illness " ( Daily Mail ) ; " something of a breakthrough " ( Channel 4 ) ; English Health Secretary Hunt ( not known for his grasp of evidence-based medicine ) congratulated US manufacturer Eli Lilly on a " massive step forward " ; " Alzheimer’s breakthrough hopes add to promise of pharma revival " ( Financial Times ).


As members will know from reading this thread, Alzheimer’s disease is the commonest type of dementia - affecting about 0.5 million people in the UK; probably well over 0.2 million in the Philippines ; approaching 50 million in the world ; and expected to increase as people get older – possibly tripling in numbers by the middle of this century. Mental health disorders are already thought to account for more " disability-adjusted life years " ( years of healthy life lost to disability and premature death ) than cancer – about a fifth of the total in " high income countries ". While Alzheimer’s may not be the actual cause of death, it often contributes ( through pneumonia for example ).



We know much about the pathology of dementia, including the commonest type ( Alzheimer’s ) but sadly there’s still no cure, and no guaranteed way of prevention; risk reduction includes the usual factors favouring a healthy lifestyle - not smoking, limiting alcohol intake, staying physically fit and avoiding obesity. It’s not just " amyloid plaques " affecting nerve cells but also inflammation with immune responses – all of which could in theory be prevented or treated.


Many research trials over the past 30 years have produced only a few drugs that manage symptoms, without stopping progression of the disease.


It’s understandable, therefore, that a " breakthrough " has been widely reported in the past week. A true breakthrough would indeed be good news for patients ( and the pharmaceuticals industry ) ! However, this news has to be received with caution. Patients with Alzheimer’s today are not going to benefit - at best the effect is seen only in those with the earliest and mildest signs of the disease. It could still take years before the drug is licensed and approved ; results from a further clinical trial won’t be reported until late next year ; then there’s the cost ( a worry in the UK and far greater worry in the Philippines ).


It would have been good to report this as more positive news, following on from the malaria vaccine reported in another thread. However, unfortunately the " Alzheimer’s drug " is no breakthrough ! Only tiny differences were found in " cognitive scores " ( tests of thinking, memory, problem-solving and language ability ) - which may mean little or nothing for the quality of life and may even have occurred by chance.


Let’s hope the results from the further trial next year are more convincing, and / or some other treatment(s) prove as effective for Alzheimer’s as recent advances in treatment for other common serious diseases like cancer, heart conditions and hepatitis C.


http://www.bmj.com/content/351/bmj.h4064