Editor's note: This conversation originally aired in May, before the federal approval of Alzheimer's drug aducanumab.
It’s estimated that one in nine people older than 65 in Nevada lives with Alzheimer’s disease. The state also ranks as the third fastest growing dementia population in the country.
Dr. Jeffrey Cummings is a UNLV research professor and the director of UNLV’s Center for Transformative Neuroscience.
The National Institute on Aging awarded the center, which is less than a year old, $3 million to help its work on different drugs aimed at combating Alzheimer's disease.
Cummings explained that for the past five years he and his colleagues have been publishing an annual review of all the medications that are in development for Alzheimer’s disease. This grant will allow them to expand their operation, providing even more information to the researchers working on medications.
“We’re going to be able to do a much deeper dive to understand which trials are succeeding, which ones are failing, which drugs are working, which ones probably do not work. We’ll have so much more information that can help guide the field,” he said.
Cummings said the expanded database that they’re calling the Clinical Trial Observatory will help researchers better understand where their project fits into the overall picture and compare where they are to others.
There hasn’t been a new medication approved for Alzheimer’s for 20 years. It is extremely difficult to find treatments for Alzheimer’s because scientists are still working on the biology of the disease, Cummings said.
“It’s like flying an airplane and building it at the same time,” he said, “It is very difficult to do that. We don’t understand the biology as well as we need to, and yet, we can’t wait until we have a perfect understanding to try to develop new drugs.”
Cummings said researchers are in the process of learning about how the disease impacts the brain while they’re developing treatments.
There is a promising treatment for the disease that Cummings believes might be approved by the FDA as soon as June.
It is called aducanumab.
Unlike other medications for Alzheimer’s disease, this drug doesn’t treat the symptoms. Instead, it works to attack the root of the problem, which are toxic proteins that pile up in patients’ brains.
“This is an anti-body,” Cummings explained, “It uses the immune system to attack the abnormal proteins that accumulate in the brain of Alzheimer’s disease. We can see from scans that show us that protein that this drug dramatically reduces the amount of this protein in the brain.”
He said trials of the drug show benefits to people with mild Alzheimer’s in their memory and ability to carry out daily living.
Cummings said there is a very active dialogue going on around the new medication because the trial was terminated early when about halfway through there were no indications of a benefit.
However, researchers continued to collect the data of the trial participants and found they needed to be on higher doses for a longer time to actually get the benefit from the medication.
Dr. Aaron Ritter of the Cleveland Clinic’s Lou Ruvo Center for Brain Health is also optimistic about the medication. He said Alzheimer’s disease research is entering a new phase where medications can actually impact the progress of the disease.
“I think we’re at that horizon point where we’re going to start to see several medicines that can turn this disease into more of a chronic disease where we can help manage the symptoms a lot better and slow down the disease considerably,” he said.
Ritter said the medications being worked on right now could give years back to patients and their families. It could mean that people with mild cognitive impairment or mild dementia stay in that stage of the disease instead of having the disease progress to complete Alzheimer’s.
“So, a disease that may be 15 years, turns into a 25-year disease and those are important years back that we could give patients,” he said.
Cummings also noted that similar drugs that use the immune system to attack toxic proteins could be used for other brain diseases that work like Alzheimer’s.
For instance, Parkinson’s, Huntington’s, and ALS – otherwise known as Lou Gehrig’s Disease – are all caused by the build-up of different toxic proteins, but if a patient’s body can be triggered to attack those proteins, the diseases could be slowed down.
“If we can discover how to change this protein toxicity and the protein accumulation in the cells, we could have treatments that would go across neurodegenerative disease,” he said, “It would be a breakthrough moment.”
UNLV’s Center for Transformative Neuroscience is not the only brain science center in Southern Nevada that received an important grant. Ritter’s team at the Lou Ruvo Center for Brain Health also received $3.3 million from the National Institute on Aging to establish the Nevada Exploratory Alzheimer’s Disease Center.
Ritter said the new center will be part of a nationwide project that has been going on for 20 years. The project has been following thousands of people over that time. Participants range from people going through normal aging to those with Alzheimer’s disease.
The new center in Nevada will focus on an area that has seen very little research.
“Our focus as part of this study is to study how the rural experience, how people living in small towns, how they experience Alzheimer’s disease,” he said, “Are there things in the environment, are there things growing up in the small town that may either protect folks from developing Alzheimer’s disease or make it more likely to develop Alzheimer’s disease?”
The other centers involved in the research are located in urban centers but Las Vegas’ proximity to rural areas allows researchers to get the information that has been lacking about rural communities.
Dr. Jeffrey Cummings, UNLV Research Professor, Director of UNLV’s Center for Transformative Neuroscience; Dr. Aaron Ritter, Neuropsychiatrist, Clevland Clinic’s Lou Ruvo Center For Brain Health
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