Scientists in the USA have completed a small but intriguing study which seems to suggest that drugs used to reduce elevated blood sugar levels in diabetics could also benefit patients with Alzheimer’s disease.
The researchers, from the University of Virginia Health System and Case Western Reserve University, say their study suggests that Takeda and Eli Lilly’s Actos (pioglitazone) could represent a new approach to treating Alzheimer’s by interfering with inflammatory reactions in the brains of patients.
"We believe that the drug may reduce the body's inflammatory reaction to one of the toxic components that builds up in Alzheimer's, called amyloid plaque," said Dr David Geldmacher, an associate professor of neurology at UVA.
The trial enrolled 25 people with mild-to-moderate AD and found that Actos improved patients’ memory and ability to carry out every day tasks. While it was too small for investigators to be sure of the effects, the findings are promising enough to carry out larger studies, they said.
The research was presented this week to the world's largest Alzheimer's conference, ICAD 2006, in Madrid, Spain.
"We don't know exactly how pioglitazone works in Alzheimer's, but there are two possibilities," Geldmacher said. "It could be that the drug reduces the body's response to the amyloid protein found in Alzheimer's. Or, it could be that this drug helps brain cells function. The real advantage is that it's a completely novel approach to treating the disease."
In the next few years, Geldmacher and his colleagues hope to study the effectiveness of pioglitazone in a trial involving of 200 to 300 Alzheimer's patients.
"If it works, this treatment might allow people to better hold on to memory and brain function over a period of time, despite having Alzheimer's," Geldmacher said.
He also suggested that Actos could be used in combination with existing drugs for Alzheimer’s which work by boosting neurotransmitter levels in the brain. These include the cholinesterase inhibitors for milder forms of the disease – Pfizer/Eisai’s Aricept (donepezil), Johnson & Johnson’s Exelon (rivastiogmine) and Razadyne ER (galantamine hydrobromide) and the rarely used Cognex (tacrine) – and Forest Laboratories’ glutamate NMDA receptor agonist Namenda (memantine) for moderate-to-severe AD.
Last year, the global market for Alzheimer’s drugs was a little over $2.6 billion, but should more than double to reach $5.5 billion by 2009, according to data compiled by Millennium Research Group.