studies Aim to Treat Alzheimer’s Before It Starts

By Keridwen Cornelius

Researchers at Barrow Neurological Institute want you to help find a cure.

Until recently, the strategy for tackling Alzheimer’s was a bit like the strategy for handling hurricanes: Clean up blown-down houses rather than build sea walls. Researchers tested therapies on individuals with cognitive impairment after the majority of their key memory neurons were decimated. More than 99 percent of potential Alzheimer’s drugs failed clinical trials, according to a 2014 study published in Alzheimer’s Research & Therapy.
Now, in their quest to treat Alzheimer’s, researchers are seeking a novel group of recruits: people who don’t have Alzheimer’s.
“The idea that we can try to head off the symptoms before they begin was revolutionary three years ago but is now taking root in the research space as a practice that could become common in the future,” says Dr. Marwan Sabbagh, director of the Alzheimer’s Disease and Memory Disorder Division at Barrow Neurological Institute in Phoenix.
Currently, Barrow is recruiting people ages 65 to 85 with normal memory for an international trial called EARLY. Volunteers will be given a PET scan to screen for amyloid, a protein that clumps into plaque around neurons. Studies have found amyloid can begin to gunk up the brain 20 years before the symptoms of Alzheimer’s appear.
Participants who test positive for amyloid will be given a placebo or an experimental beta amyloid cleaving enzyme inhibitor (BACE) that attempts to reduce amyloid production. They’ll take the oral medication daily for about three years.
EARLY, also known as A5, is the sequel to A4 (Anti-Amyloid Treatment in Asymptomatic Alzheimer’s), an ongoing study that wound down recruiting at Barrow this summer. A4 is similar, except it’s testing solanezumab, an infusion-delivered drug that scavenges amyloid and removes it from the brain.
A4 and A5, along with three other preventive Alzheimer’s studies taking place around the world, aim to enlist thousands of participants. That’s challenging, since the majority of PET-scanned participants discover they don’t qualify because they test negative for elevated amyloid, Sabbagh says. “It’s the needle in the haystack approach, which the field is still going to need to refine.”
Eventually, scientists at Barrow and Arizona State University hope to create a “needle detector.” They’re developing a blood test that detects tau – another prime suspect protein in Alzheimer’s. In addition, ASU scientists are working on a blood test that could reveal signs of presymptomatic Alzheimer’s in RNA. Blood tests would be simpler and far less expensive than PET, which can cost $5,000 per scan.
All these efforts will be necessary to triumph over this incurable disease that impacts 5.4 million Americans. “I’m very sure that one or many of these approaches will be successful,” Sabbagh says. “The idea that we can prevent or delay the onset of symptoms – 10 years ago I would have said, ‘You’re dreaming.’ Now it’s on our radar.”
However, Sabbagh stresses, “We need people to participate. That’s the only way we’re going to get answers and treatments… Don’t wait for your symptoms to get worse. Now is the time to engage.”
To be screened as a possible participant, call 602-406-7165.