A cure for Alzheimer’s. Think about that.  If you are not excited about the possibilities, you have not been reading the facts.  Over 4.5 million people in the U.S. suffer from Alzheimer’s; it’s a debilitating disease, which is very costly in terms of treatment and health care expenses, and results in approximately 7% of all hospitalizations.  Because of this, pharmaceutical companies have been focusing on a cure for Alzheimer’s.

I spoke to Jin-Moo Lee, M.D., Ph.D., assistant professor of neurology at Washington University School of Medicine, and attending physician at Barnes-Jewish Hospital in St. Louis, MO, who has published multiple journal articles on Alzheimer’s.  I asked him about the state of therapeutic options and he stated, “There are several drug therapies that are currently available and are mildly effective.  The problem is that the drugs available today are not started at the earliest stages of the disease.  Once brain damage occurs, there is no method of regenerating the lost tissue.”

To date, all approved Alzheimer’s drugs are designed to slow the progression of the disease. One series of promising drugs are PBT2 and PBT3.  PBT2 is just entering phase IIb clinical trials and is based on regulating copper and zinc levels within the brain.  Phase II clinical trials indicated that differences between PBT2 and the placebo were statistically significant (30% after 12 weeks) in reversing dementia symptoms.

William E. Klunk, M.D., Ph.D., associate professor of psychiatry at University of Pittsburgh School of Medicine in Pittsburgh, PA, and a Ronald and Nancy Reagan Research Institute Award winner for Alzheimer’s research, assessed the possibilities of new drug therapies.  He stated, “What we have learned is that we now have new drugs that can effectively change the course of this disease.  However, there is not yet a guarantee that these drugs will do that, but I hope they will.  We will have to wait to see the results of several ongoing clinical trials.” 

If all goes well, PBT2 could become available in a year or two.  When it does, patients would see immediate benefits with a better quality of life.  Hospitals will see a reduction in costs of treating patients with a secondary diagnosis of Alzheimer’s, and faster recovery times from fall-related injuries, such as hip fractures and pneumonia, would be enabled.  Besides cancer and heart disease, I can’t think of another disease cure that would have a greater impact.

I’m sure I’m not the only one who wonders why an early diagnosis for Alzheimer’s is so important if there is no cure.  In fact, there are several drugs out that can slow the disease progression and several on the way that promise to reverse the effects of Alzheimer’s.  Considering Alzheimer’s costs over $170 billion each year and is the seventh leading cause of death, early diagnosis can be crucial.

Currently, PET scans are the only FDA-approved test to diagnose Alzheimer’s.  Other tests, such as clinical assessment, spinal fluid (tau protein), and EEGs, are used together in a process of elimination, diagnosing the disease with 80 to 90% accuracy.  Unfortunately, this combination of tests can total thousands of dollars and is far too expensive to be considered as a screening method. 

John Q. Trojanowski, M.D., Ph.D., director at the Institute on Aging, director at the Alzheimer’s Disease Center, co-director at the Center for Neurodegenerative Disease Research, Marian S. Ware Alzheimer Program, Department of Pathology and Laboratory Medicine, University of Pennsylvania School of Medicine, and a leading researcher of Alzheimer’s stated, “There are several types of biomarkers being studied, and proteins are the most promising.  Plasma and urine samples are also new tests being used.  Both of these have shown a lot of promise and can be performed easily and cost effectively.” 

Clinical trials for a serum protein-based algorithm used for the detection of Alzheimer’s show that blood tests have about 95% accuracy when patient demographics are included.  Dr. Trojanowski noted, “Specificity in the 90% range is high enough to guide a diagnosis, but people would like to see 100% specificity and sensitivity in a biomarker test.  These numbers for any test are rare.  So getting a test for Alzheimer’s with a sensitivity and specificity in the 90% range would be deemed informative.”

Costs for an Alzheimer blood test are projected to be around $250 to $450, considerably less than a PET scan.  Physicians will also have a tool for determining the effectiveness of their prescribed treatment, which should allow more Alzheimer’s patients to avoid hospitalization.  I see this as significant taking into account that it costs over twice as much to treat a patient with Alzheimer’s as a secondary diagnosis.