School of Medicine

Solving the Alzheimer’s Disease Therapy Drought

From MD Magazine

In just a short decade of Gregory Day’s young career, the US multiple sclerosis (MS) therapy market has exploded from just a handful options to 17 US Food and Drug Administration (FDA)-approved agents for multiple mechanisms.

Day, MD, MSc, assistant professor, Washington University School of Medicine, Knight Alzheimer Disease Research Center, St. Louis, has reflected often on this fact — how a complex condition went from having only a few treatments to a cabinet’s worth of drugs in only 10 years. It especially lingers on him because it’s a trajectory he hopes for Alzheimer’s disease (AD) therapies.

In an interview with MD Magazine at the 70th annual meeting of the American Academy of Neurology (AAN) in Los Angeles, CA, this week, Day called AD a challenging disease, which somehow may be an understatement. At the end of 2017, the National Institutes of Health (NIH) reported an estimate that approximately 6 million adults in the US have either AD or mild cognitive impairment — a telling early symptom of the disease. Despite this, it has been 15 years since a drug was approved for AD.

The reasons why AD research fails to reach marketable progress is both varied and self-perpetuating: its aggressive pathology is complimented by limited diagnoses, reducing the pool of early-diagnosed patients for clinical trials. In diagnosing these issues, Day mapped out a way for researchers to bring about a clear resolution.

He explained that AD is a condition that presents insidiously in patients. Unlike the relapsing or remitting forms of MS, Alzheimer’s is relentlessly progressive. Indeed, a majority of Americans who have symptomatic AD either don’t receive a diagnosis in the clinic, or receive a diagnosis of dementia that doesn’t conclude on what has driven the symptom. When the diagnosis eventually comes, physicians can only tell patients about its progression and their eventual death.

“And without people knowing what the diagnosis is, I don’t think we’re going to have the opportunity to assign them appropriately to clinical research,” Day said. “We’re not going to have opportunities to learn about their care or their progression, or evaluate therapies in that population.”

  Read more at MD Magazine.