The Arizona Republic / Dr. Eric Reiman
By the time today's young adults become senior citizens, the number of Alzheimer's patients and family caregivers is projected to create an overwhelming problem. Researchers have developed a growing number of investigational medication and vaccine treatments to slow and prevent the disease, some of which are now entering clinical trials in afflicted patients. Moreover, they have raised the possibility that some already-available medications, dietary supplements, and healthy lifestyle interventions might reduce a person's risk. An even modestly effective risk-reducing treatment would have an extraordinary public health impact.
But the hope of finding effective Alzheimer's prevention therapies will never be realized unless we are able to develop a rapid and rigorous way to test them. It currently takes too many healthy research subjects, too much money, and too much time - longer than the life of a drug company's patent - to test a suggested prevention therapy in a clinical trial. It's just not practical to wait so long to determine which healthy subjects develop memory and thinking problems.
My colleagues and I have been using imaging techniques to track Alzheimer's-like brain changes in healthy people carrying a common Alzheimer's susceptibility gene. We have suggested how these markers of disease progression could be used to test promising risk-reducing and prevention therapies without having to wait many years to determine whether healthy subjects develop symptoms. While this strategy and others like it offer hope, more needs to be done. What can Congress do to find effective Alzheimer's prevention therapies in the shortest possible time? Here are my recommendations:
- Encourage pharmaceutical companies to include brain images and other biological markers of disease progression in clinical trials of every disease-slowing treatment. If the FDA is confident a treatment's effect on biological markers of the disease predicts a good clinical outcome in affected patients, it is more likely to approve a prevention therapy showing the same disease-slowing effects without waiting to see if healthy research subjects develop symptoms.
- Give pharmaceutical companies a compelling incentive to evaluate risk-reducing and prevention therapies. By offering to extend a drug's marketing exclusivity, awarding research grants and providing tax breaks, Congress has promoted the development of "orphan-drug" treatments for rare disorders. Imagine what similar incentives could do to promote the identification of an effective Alzheimer's prevention therapy.
- Provide federal funding to evaluate the risk-reducing effects of available medications, dietary supplements, and otherwise healthy lifestyle interventions for which industry lacks a patent incentive.
- Make the scientific understanding, treatment and prevention of Alzheimer's disease a national priority.
In 1961, President Kennedy called on the nation to send a man to the moon and return him safely to Earth before the end of the decade. With fewer scientific resources to address that problem than are now available to the problem of Alzheimer's disease, the nation completed the job ahead of schedule. Later this year, the Alzheimer's Study Group will call on the nation to address the problem of Alzheimer's disease in a transformativeway. Let's stop and end Alzheimer's without losing another generation.