Living with dementia magazine June 2011

A new research programme launched in May could result in new treatments for dementia within ten years, by Caroline Bradley. 

Identifying new treatments for dementia is a process of trial, error and very occasional success. Currently, there are only eight final (phase III) trials of treatments for dementia underway worldwide. Each of these has between a one in five and one in 10 chance of success.

The Society aims to make a significant difference to the number of trials with its new Drug Discovery programme. The plan is to test treatments that are already licensed for other conditions to find out if they could benefit people with dementia. The drugs we are focusing on have additional properties that may be effective in treating the changes that occur in the brain in Alzheimer's disease.

Six drugs have been identified as candidates for fast-tracking to the clinical trial stage. This will involve final laboratory testing to make sure the drugs are ready for the trials. The plan is then to test the three most promising drugs over five to 10 years. It is hoped the first trial will begin in just two years.

Professor Clive Ballard, Director of Research, says,

'Eight phase III trials is simply nowhere near enough. Our Drug Discovery programme can make a serious contribution to the number of trials happening and more trials will put us into the realm of possible success.'

New tricks for old drugs

Drug discovery is an expensive business. It costs 1 billion US dollars, approximately £612.7 million, and takes 20 years to deliver an effective treatment from scratch.

The six candidate drugs in the Drug Discovery programme were all developed to treat other conditions. This means they have already been tested and proved safe for use so some of the most expensive parts of the trial process, and most likely barriers to success, have already been completed.

As the drugs are already available they will be cheaper and quicker to translate into dementia treatments if successful. The cost of testing three drugs over a five to 10 year period will be £15 million, a significantly less costly approach.

It's not unusual for drugs to have more than one use. Professor Ballard says,

'Most drugs do far more than one thing. Viagra is probably the best example of a drug that is widely used for something it wasn't developed for (it was originally intended as medication to lower blood pressure).'

Promising candidates

The six drugs that might have properties to treat dementia come from a shortlist of 15 drugs currently used to treat conditions such as heart disease, inflammation and infection. A panel of experts has rigorously assessed them and they all offer the real possibility of treating the causes of dementia.

All of the candidates are 'off patent' drugs, which means there is no financial incentive for pharmaceutical companies to develop them further. Drug companies are granted patents for up to 20 years on new drugs they discover or invent. Once the patent expires other drug companies can make generic versions of the drug and the profits diminish.

Alzheimer's Society has decided to take action to ensure that the possibilities offered by these drugs are not lost.

Research fellowships

The first task is to establish the most suitable doses of these drugs for people with dementia. This involves finding a balance so that people can get the maximum possible benefits from the drugs at a level that will be safe. This work should be completed by the autumn, which is when the names of the six drugs will be revealed.

The Society then plans to launch two research fellowships that will carry out laboratory research to thoroughly investigate whether the drugs can work as treatments for Alzheimer's disease. The fellowships will last approximately three years with clinical trials beginning after one year.

The researchers will be using the drugs to target the causes of Alzheimer's disease in the hope of improving symptoms. Current drug treatments (anticholinesterase inhibitors) give people an average of nine months of improvement in memory and cognition. However, on average, people live for just over four and a half years following diagnosis. The aim of the Drug Discovery programme is to develop treatments that will benefit people throughout this period, from their diagnosis until their death. 

It is possible that the new treatments could bring improvements that help people to live longer, as well as improving symptoms. This will be investigated as part of the clinical trials, where the potential drug treatments will be tested against a placebo.

The Society plans to invest £15 million over five to 10 years to thoroughly investigate the possibilities that these drugs offer. We will keep you up to date on progress and on how to get involved once the trials begin.