- According to the WHO there are more than 55 million people who have some type of dementia.
- Of that number, more than 60% live in low- and middle-income countries.
- A new study affirms that a combination therapy would be useful to delay the progression of Alzheimer’s.
A working group of experts has reconsidered what is clinically important for slow the progression of Alzheimer’s disease during clinical trials, including the impact of treatment over time and the need for combination therapies.
On this topic, The Journal of the Alzheimer’s Association published the group’s findings and recommendations:
Delaying the progression of the disease (rather than delaying it, which can happen over time) has important and significant benefits for patients and their families, especially in early stages of Alzheimer’s when cognition and memory are still fully or mostly intact.
A statistically significant benefit in an 18-month clinical trial may indicate and lead to even more relevant change when projected into the future.
How to make Alzheimer’s progress?
A single intervention on the neurological changes associated with dementia is unlikely to have a large clinical effect on its own. To achieve greater impact, combination therapies are needed, in the same way that high blood pressure and cancer are treated today.
The process of Alzheimer disease it attacks the brain for years, even decades, before a person has problems with memory and thinking. However, clinical trials of disease-modifying therapies in the symptomatic stage typically last about 18 months.
Looking at the results of drug trials, the working group brought together by the Alzheimer’s Association looked at how patients, families and the scientific community assess what is important when it comes to slowing the progression of Alzheimer’s disease.
“Delaying neurological decline, even for four to six months, in the early stages of Alzheimer’s disease can lead to preservation of function for patients, which can be very important to them and their families. The longer a person can delay the loss of independence and continue to participate in activities of daily living, the more significant these results will be,” says Ronald Petersen, MD, a Mayo Clinic neurologist.
Changes in the brain due to Alzheimer’s disease do not happen in isolation. A person who has cognitive impairment usually has other neurodegenerative processes that occur at the same time.
Over the course of an 18-month clinical trial, “the observed clinical impact of a single intervention is reasonably expected to be fairly modest,” the authors write. However, if the therapy continues for a longer time and its efficacy is sustained, the cumulative benefits will be more evident.
The task force notes that just as high blood pressure and cancer are treated with a variety of drugs, a variety of interventions are also needed to address complex neurological changes and problems related to memory and thinking.
A 2021 Alzheimer’s Association Research Roundtable article referenced the Food and Drug Administration’s description of clinical significance as when “treatment has a significant positive effect on the way a person feels, functions, or survives.” .
Interpretation of clinical relevance will be part of the conversations physicians will have with patients and their families when considering the benefits, risks, and potential pitfalls of newly approved disease-modifying therapies to treat Alzheimer’s disease.
Also read:
All about Alzheimer’s: symptoms, risk factors and prevention tips
The 10 most surprising medical news of 2022: From innovative drugs to advances against cancer
Alzheimer’s could be diagnosed through the retina