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Has a pioneering new Alzheimer's drug paved the way for the future of dementia research?

Professor John O'Brien - Dementia Blog

Published: 04 February 2022

There are currently 55 million people living with dementia worldwide and with the proportion of older people in the population increasing in nearly every country, this number is expected to increase.

We started the new year with well-publicised predictions from the University of Washington’s Institute of Health Metrics and Evaluation (IHME), published in the Lancet Public Health, that the number of people with dementia globally will triple by 2050.

Although we have treatments to help with some of the symptoms of the main cause of dementia, Alzheimer’s diseases, we have yet to find ways of slowing the disease process.

Landmark moment

The US conditional approval of aducanumab in June 2021, was significant because it is the first drug to target amyloid, a protein that builds up in the brains of people with early stages of Alzheimer’s disease.

Clinical trials found that aducanumab slows the progression of early Azheimer’s disease, and whilst the clinical benefit was not clear, this marks a significant moment in dementia research. Whereas other existing treatments help to ease symptoms, this is the first drug approved by a major regulator to target one of the biological contributors of the disease.

More recently the European Medicines Agency (EMA) rejected Biogen’s market authorisation application for aducanumab to be used as a treatment of mild cognitive impairment and mild Alzheimer’s dementia in Europe. Although this may be disappointing to people with Alzheimer’s disease and their families and carers, it is still a landmark decision as it is the first time that a disease modifying therapy for any type of dementia has had sufficient evidence to apply for approval in Europe.

Having evidence from well conducted clinical trials was essential to allow the EMA to make a well informed decision about the benefits and harms of treatment, and further studies will be undertaken to gain more insights. It is clearly essential that only safe and effective medicines should be made available to people with Alzheimer’s disease and other causes of dementia

Reasons to be optimistic

Evidence like this can only be gained by the involvement of people in research, and a third of those who took part in the UK clinical trials were matched through Join Dementia Research.

Although the clinical benefit wasn’t considered by the EMA to be clear, the fact the drug caused removal of amyloid from the brain is a very important proof of concept in the search for new treatments.

We have reason to be optimistic though, as there are over 100 different compound drugs in clinical trials taking place worldwide.

Dementia is an area of strategic focus for the NIHR. Since the Dementia Themed call in 2011, the NIHR has funded an extensive portfolio of dementia research and continues to invest in research to tackle the growing dementia challenge.

For example, the NIHR Public Health Research Programme’s dementia call is currently open until April 2022.

The research community can recruit participants through Join Dementia Research - a national service which matches volunteers with study teams. Join Dementia Research is run by the NIHR in partnership with Alzheimer’s Research UK, Alzheimer’s Society and Alzheimer Scotland. Some researchers, including PhD student Anne-Marie Greenaway have recruited 100% of their study participants through Join Dementia Research.

Many people researching dementia find value in the NIHR’s Dementia Researcher, an online network for early career researchers. It includes a wide variety of content and opportunities to engage; from funding information and ‘ask an expert’ forum to podcasts and blogs.

As researchers, we know only too well the global dementia challenge we face, but the NIHR dementia research focus and the recent aducanumab news should give us all reason to be optimistic. It is now becoming increasingly clear that it is a case of “when” not “if” a disease modifying therapy will become clinically available. 

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