Are we ready for an Alzheimer’s disease-modifying treatment?

Fadi Haddadeen|27th September 2019

During the last five years, Blue Latitude Health has devoted time to understanding the landscape of Alzheimer’s Disease and dementia-causing illnesses. From learning about pharmaceutical treatments to smart home technologies, we are proud to have invested in understanding the problems faced by healthcare professionals, patients and carers with a view towards easing the frustration experienced by the stakeholders impacted by this devastating illness.

However, Alzheimer’s disease-modifying treatments (DMTs) have not progressed as much in the last 15 years as we all hoped. With the rate of diagnosis increasing every year, the number of people living with Alzheimer’s disease in 2050 is estimated to exceed 130 million worldwide. The pharmaceutical treatments available today only address the symptoms of the disease rather than the disease itself (symptomatic treatments rather than etiotropic treatments), and the effects of those drugs are considered ‘modest’.

There are several reasons for this lack of innovation. Although the science has rapidly advanced in many therapy areas, we still know relatively little about the brain. This is both due to the complexity of the central nervous system and the blood brain barrier, which provides a protective shield around the central nervous system that is difficult to permeate, and the challenge of finding animal models that can suitably predict human responsiveness during the clinical trial process.

“The number of people living with Alzheimer’s disease in 2050 is estimated to exceed 130 million worldwide”

As with many neurological diseases, Alzheimer’s disease is present long before the symptoms begin to show in a notable way. Without recognisable symptoms, patients will not visit their doctors, waiting until after they have begun to experience symptoms of the disease that impact their quality of life. Some will not see a doctor until the disease has significantly progressed. As it is easier to prevent neurodegeneration (neuron death) than to reverse it, neuroscientists are starting to look for early markers, through genetic tests or blood tests, in order to diagnose and treat neurological diseases before degeneration happens.

Three reasons for industry to keep investing

The three main arguments to keep investing in a DMT despite the recent failures are rooted in morality, demographics, and health economics.

The moral argument:

Living in a society that invests effort in developing technologies and treatments for Alzheimer’s disease will help defend a significant percentage of our aging population and their caregivers from what is considered the most feared disease of people over the age of 60.

The demographic argument:

There are 850,000 people living with dementia in the UK alone, with an additional 225,000 developing dementia every year. On top of that, there are 670,000 unpaid family caregivers whose quality of life has been negatively impacted by this disease, illustrating that in many cases care is provided by families instead of healthcare professionals.

The economic argument:

If dementia care were a country it would be the world’s 18th largest economy, ranking between Turkey and Indonesia. Dementia costs the UK alone £26.3 billion a year. Ensuring an effective healthcare system is deployed will allow a bigger chunk of that money to go back to the families and communities affected by Alzheimer’s disease, improving their quality of life.

Highlighting the challenges of introducing a new Alzheimer’s disease treatment to healthcare systems worldwide would also benefit people with age-associated cognitive decline (AACD) or mild cognitive impairment (MCI), who might have similar needs to people with dementia.

 

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