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Two drugs show promise in slowing Alzheimer’s progression

Two companies have announced new progress in the development of the first drugs to slow Alzheimer's disease. Researchers found the drugs helped reduce cognitive loss in patients with mild symptoms, but some observers say the improvements are too small and uncertain. Keith Fargo of the Alzheimer's Association joins Judy Woodruff to discuss the findings.

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  • JUDY WOODRUFF:

    Let's look closer at some interesting news out today from a major conference on Alzheimer's disease here in Washington.

    Two drug companies, Eli Lilly and Biogen, announced new progress in the development of the first drugs to slow the progression of the disease, rather than simply alleviating symptoms. Both drugs target the buildup of amyloid plaques, which many believe contribute to the disease.

    Researchers found the drugs helped reduce cognitive loss in patients who had mild symptoms. But some observers in the field say the improvements for patients are too small and uncertain.

    Here to discuss these developments is Keith Fargo. He's the director of scientific programs and outreach for the Alzheimer's Association.

    Keith Fargo, welcome to the program.

    So, some promising news. Let's take these drugs one by one. They're difficult to pronounce, so I'm going to give it a try.

    Solanezumab…

  • KEITH FARGO, Alzheimer’s Association:

    Correct.

  • JUDY WOODRUFF:

    … is the first one. What are the findings in connection with it?

  • KEITH FARGO:

    So, the findings here are, really, for the first time ever, we have a drug company reporting out the results of a drug study showing that their drug may actually slow the progression of Alzheimer's disease in the brain.

    When people think about Alzheimer's disease, they normally think of the cognitive symptoms, memory loss, et cetera. But Alzheimer's disease at a core level is a universally fatal disease of the brain. And the currently available treatments for Alzheimer's disease do nothing to slow down the progression of that disease. They really only treat cognitive symptoms and only for a period of time.

    And these two new potential medications look like they may actually slow the progression of the underlying disease.

  • JUDY WOODRUFF:

    So, what is in this drug, and what does it do to the brain?

  • KEITH FARGO:

    So, this — Solanezumab and the other drug we're discussing or we will discuss actually are antibodies against a protein in the brain called amyloid.

    You may have heard of plaques.

  • JUDY WOODRUFF:

    Sure.

  • KEITH FARGO:

    Senile plaques, they used to be called, or amyloid plaques. Both of these attack the protein that makes up that plaque.

  • JUDY WOODRUFF:

    And destroy it or…

  • KEITH FARGO:

    Exactly, so they may help stop it from clumping together in the first place or they can help to clear it out of the brain. So the idea is to slow down the formation of those plaques.

  • JUDY WOODRUFF:

    Now, the second drug that there is some excitement around today is Aducanumab. What is the difference there and what exactly does it do?

  • KEITH FARGO:

    Well, they're somewhat similar, in terms of the fact that they're both antibodies.

    They target different parts of the proteins, so they may have — and we don't fully understand all of the mechanism yet, but they may work a little bit differently, although at the end of the day they're both antibodies and they both do target that amyloid that makes up the plaque.

  • JUDY WOODRUFF:

    We are hearing, as we said in the introduction, though, from some other researchers that it's still early, that there's not a big enough sample. What are you and the others at the Alzheimer's Association say about that?

  • KEITH FARGO:

    Those are all very valid concerns that we share. These are exciting results that we have seen at the international conference here this week, but you're not — with drug development, you're not done until you're done.

    And the fact is that the trial for Aducanumab was a phase one trial, which means I think less than 200 people were in that trial. The trial for Solanezumab is several thousand, because that's actually a phase three trial, but you still have to repeat that and make sure that what you saw the first time around, you see again in a second study.

  • JUDY WOODRUFF:

    So, what happens next with regard to both of these drugs.

  • KEITH FARGO:

    Well, the drug Solanezumab is already being studied in a second phase three study as we speak. And we should see the results of that probably in 18 months to two years.

    And then the other drug, Aducanumab, the company that makes that drug has just launched two large phase three trials. And we should see the results of those in two to three years.

  • JUDY WOODRUFF:

    So, Keith Fargo, who for — for people out there who have a family member, for someone who is worried about having Alzheimer's themselves, when could they look possibly to see something like this — if it's proven effective, when could they actually have access to one of these?

  • KEITH FARGO:

    For both of these drugs, you're looking at least 18 months to two years before these things are available from your doctor.

  • JUDY WOODRUFF:

    So it's a while.

  • KEITH FARGO:

    It is. It is a while.

  • JUDY WOODRUFF:

    Now, the other little bit of I guess interesting news — it's not promising — that we were hearing about yesterday is that the findings about women with Alzheimer's, that not only are there more women, many more women than men who have Alzheimer's, but that the progression of the disease is much faster in women. What is known about that?

  • KEITH FARGO:

    Well, I would actually say that it is promising, in that I think it tells us that we're learning more about the disease.

    So, as you mentioned, Alzheimer's disease is much more common in women than men. Women are essentially twice as likely to have Alzheimer's disease than men are. The conventional wisdom for many years was that it was simply because women live longer and age is the largest risk factor for Alzheimer's disease. But scientists are now seeing that maybe that's not the case. Maybe there are differences between men and women that can account for women being actually at higher risk for Alzheimer's disease other than simply longevity.

  • JUDY WOODRUFF:

    Are there theories about why?

  • KEITH FARGO:

    There are.

    And, of course, the first thing that springs to mind for many people is there may be hormonal differences. But that may be a little simplistic. Certainly, there are different life courses for men and women, especially men and women who are of the age to be at the highest risk for Alzheimer's disease now.

    Certainly, if you think about educational opportunities in the past and how different they were for men and women, we know that education is a risk factor — or low education is a risk factor for Alzheimer's disease. Certainly, occupational opportunities have been different as well.

    And we know that high-complexity occupations are protective against Alzheimer's disease. There are also potentially genetic differences between men and women that could explain this, too.

  • JUDY WOODRUFF:

    The XX chromosomes, rather than the XY.

  • KEITH FARGO:

    Exactly.

  • JUDY WOODRUFF:

    Keith Fargo with the Alzheimer's Association, we thank you.

  • KEITH FARGO:

    Thank you.

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