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Anonymous, 2012

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CBS/AP May 16, 2012, 11:37 AM

Promising new Alzheimer's experiments may lead to cure 
(CBS/AP) [1] In a fundamental shift in how scientists hunt for ways to ward off the devastation of Alzheimer's disease, researchers are testing possible therapies in people who don't yet show many symptoms of the disease, before too much of the brain is destroyed.

The most ambitious attempt: An international study announced Tuesday will track whether an experimental drug can stall the disease in people who appear healthy but are genetically destined to get a type of Alzheimer's that runs in the family. If so, it would be exciting evidence that maybe regular Alzheimer's is preventable too. 
[2] A new trial of the leading experimental Alzheimer's drug Crenezumab is set to begin. Scientists are hoping to prevent what they think is the root cause of disease - the buildup in the brain of amyloid protein. 

According to CBS This Morning, 300 people in Colombia who have the Alzheimer's gene through their family but don't have symptoms, will be offered an experimental drug called Crenezumab. The subjects will receive the drug for up to five years. It may be expanded to 24 Americans who also are at a high risk of getting the disease.

[3] Researchers hope the drug can prevent the disease, especially in people who seem predestined to get it. Dr. Eric Reiman, executive director of Banner Alzheimer's Institute and the lead researcher of the new drug prevention study, said they hope to administer the drug before these people started showing signs of Alzheimer's.

"(There's) no guarantee these treatments will work, but we have a shot. We're very excited about that," he told CBS This Morning.

A second study will test whether a nasal spray that sends insulin to the brain helps people with very early memory problems, based on separate research linking diabetes to an increased risk of Alzheimer's.

The new focus emerges as the Obama administration adopts the first national strategy to fight the worsening Alzheimer's epidemic - a plan that sets the clock ticking toward finally having effective treatments by 2025.

"We are at an exceptional moment," with more important discoveries about Alzheimer's in the last few months than in recent years, Dr. Francis Collins, director of the National Institutes of Health, declared Tuesday.

But a meeting of the world's top Alzheimer's scientists this week made clear that meeting the 2025 deadline will require developing a mix of treatments to attack the different ways that Alzheimer's damages the brain - much like it can take a cocktail of drugs to treat high blood pressure or the AIDS virus.

Perhaps more importantly, it will require testing possible drugs before full-blown Alzheimer's sets in, when it may be too late to do much good. After all, [4]Alzheimer's starts ravaging the brain at least a decade before memory problems appear. And doctors don't wait until the worst symptoms appear before treating heart disease, cancer or diabetes, noted Dr. Reisa Sperling of Harvard Medical School.

"Once the train leaves the station of degeneration, it might be too late to stop it," Sperling said. "We need to define the critical window for intervention."

Future therapy is far from the only goal of the first National Alzheimer's Plan. It's a two-pronged approach, promising to provide better and support for overwhelmed families along the way.

"A lot more needs to be done and it needs to be done right now, because people with Alzheimer's disease and their loved ones and caregivers need help right now," Health and Human Services Secretary Kathleen Sebelius said in announcing the plan.

Among the first steps: A new website - http://www.alzheimers.gov - that Sebelius called a one-stop shop for families offers easy-to-understand information about dementia and links to resources in their own communities. The government will offer free training to doctors and other health providers on how to spot the early signs of Alzheimer's and care for those patients. This summer, a campaign will begin to improve public awareness of Alzheimer's, important in reducing the stigma that helps fuel late diagnosis and the isolation that so many affected families feel.

Patient advocates applauded the move, and country music legend Glen Campbell, who has Alzheimer's, appeared on Capitol Hill to urge more research.

Alzheimer's "has been in the shadows for far too long," said Eric J. Hall of the Alzheimer's Foundation of America. The plan "provides solid stepping stones toward substantial change."

[5] Already, 5.4 million Americans have Alzheimer's or related dementias. Barring a research breakthrough, those numbers will jump by 2050, when up to 16 million Americans are projected to have Alzheimer's. The number of people is expected to triple over 40 years as the population, the CBS Evening News reports.

The annual cost of care could hit $1 trillion soon. Currently, the annual cost of care is $200 billion.

There is no cure, and the five medications available today only temporarily ease some symptoms. Finding better ones has been a disappointing slog: Over the last decade, 10 drugs that initially seemed promising failed in late-stage testing, Sperling said.

[6] Moreover, scientists still don't know exactly what causes Alzheimer's. The chief suspects are a sticky gunk called beta-amyloid, which makes up the disease's hallmark brain plaques, and tangles of a protein named tau that clogs dying brain cells. One theory: Amyloid may kick off the disease while tau speeds up the brain destruction.

[7] Previous studies of anti-amyloid drugs have failed, but that new international study will test a different one, in a different way: About 300 people from a huge extended family in Colombia who share a gene mutation that triggers Alzheimer's in their 40s will test an experimental drug, Genentech's crenezumab, to see if it delays onset of symptoms. The study also will include some Americans who inherit Alzheimer's causing gene mutations.
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