AAN 2015 Research Spotlight: A New Compound for Alzheimer’s
Neurologists from all over the world converged in Washington D.C. last week, with an estimated 13,000 attendees meeting at the 67th annual American Academy of Neurology conference to learn about new research in the field.
Natalia Rost, M.D., is vice chair of the AAN Science Committee, which selected over 2,400 scientific presentations showcased at the meeting. Rost, who is also director of the acute stroke services at Massachusetts General Hospital, and associate professor of neurology at Harvard Medical School, highlighted three of the most significant research findings presented, including a compound for early stage Alzheimer’s disease, a new way to think about migraine pain, and a “game-changer” in treating strokes.
New compound for Alzheimer’s
This research was presented by Jeffrey Sevigny, M.D., senior director of clinical development at Biogen, as an emerging science abstract at the AAN annual meeting.
Rost discussed Sevigny’s study on a new compound called aducanumab, a monoclonal antibody to the aggregated beta-amyloid, in patients in the early phases of Alzheimer’s disease. It was phase 1B trial, an early trial with the primary goal to determine safety and tolerability. The investigators also looked at the results of a surrogate marker of disease progression, in this case the type of marker is a PET-scan. During the trial, 166 individuals were studied, roughly half of whom have prodromal Alzheimer’s disease, meaning very early stage, and the other half who have mild Alzheimer’s disease. The patients received monthly infusions of the compound for 52 weeks, and the study was stopped at 26 weeks to look at the results of initial testing.
Rost said this research is novel because it specifically targeted the amyloid-compound in the prodromal and mild stages of the disease.
“I think this is particularly important as we explore the concept of brain health as opposed to disease in general,” Rost said. “We’re trying to reach into the state of the brain earlier and earlier to catch the inklings of disease development.”
When the initial results were investigated the team noticed there was a higher degree of amyloid-related imaging abnormalities (ARIA), depending on disease progression as well as on the genetic allele carrier status. ARIA’s, such as presence of swelling in the brain, presence of micro-hemorrhages, and non-specific inflammation of blood product on the surface of the brain were the primary outcome for safety and tolerability, and the researchers noticed there were more of those abnormalities in patients who had more severe disease.
There were safety and tolerability findings that were dependent on the genetic allele carrier status and dependent on the dose of the medication that the team had been infusing. They also noticed that this antibody reduces the amyloid plaque across these particular stages of the disease as well as the genetic carrier status.
Based on the incidence of these adverse effects, the compound was fairly well tolerated, Rost said. “But the interesting part noted was that the incidence of these were more prevalent in those with mild, than prodromal, and more so in people carrying certain genetic alleles.”
The conclusions for work on prodromal patients is a “tidal change in the way we’re approaching the disease,” Rost said.
Next up, Bioscience Technology will highlight the research findings from Todd J. Schwedt, M.D., Mayo Clinic, on a new way to think about migraine pain.
