'Statin for the brain' vaccines in news today

[Orangeblossom]

Several vaccine-like treatments - which work more like a ‘statin for the brain’ than a traditional jab - are currently at an earlier stage of development, undergoing Phase I and II trials, said the experts.

The report estimates that a vaccine could prevent around 70 per cent of Alzheimer’s cases.

https://www.telegraph.co.uk/science/201 ... ecadewith/

[Harrison]

The Daily Telegraph article is an interesting take on the current status of Alzheimer's disease drug development. Since all of the amyloid directed treatments have failed in patients with established disease, the push has been to treat earlier and earlier. With some of those same drugs now failing to work in people when treatment starts before they have overt dementia, the push is being made for primary prevention. These studies are very difficult to do and very expensive, and it could take a decade before we know if they work. It could be that this is how amyloid needs to be targeted for a drug to work. It could also be that amyloid accumulation is not actually driving the disease and is a result of the true initiating step. What we really need are biomarkers to say if someone is on the path to dementia. ApoE4 genotype plus some other markers (for example, insulin resistance, hypertension, etc) might be useful in this regard.

[Fiver]

Boy they sure didn't provide much information about the drug candidates, did they? Some seem to be AB antibodies, and similar, to slow aggregation. But I have no idea what a "statin for the brain" is. All sorts of mixed messages in that metaphor. Not great "science communication" in that specific case.

Completely agree that we need biomarkers to know the risks and know when treatments are working.

[Orangeblossom]

I know, I tried to find out more but couldn't seem to find anything further. Am not very thrilled at the thought of a statin for the brain but will be interested to see what happens with it all. I think they are going to have to raise National insurance contributions to pay for it all, just hope some of it might work. and maybe as some GP's are doing some lifestyle factors and other things may be paid more attention to. The NHS is not known for preventative treatment I find so we will see! Maybe if it is going to save money it may change things

[Harrison]

Boy they sure didn't provide much information about the drug candidates, did they? Some seem to be AB antibodies, and similar, to slow aggregation. But I have no idea what a "statin for the brain" is. All sorts of mixed messages in that metaphor. Not great "science communication" in that specific case.

No kidding about the mixed messages with their metaphors! They seem to be using the term statin and the term vaccine very loosely. I take them just to mean taking a medicine in a preventive fashion. This is British medical journalism which has a somewhat sensationalist bent.

Regarding the treatments, my guess is they are referring to tau and amyloid antibody therapies from Big Pharma that are in Phase 3 trials. Not sure of precisely what 12 treatments they are though.

[NF52]

Since all of the amyloid directed treatments have failed in patients with established disease, the push has been to treat earlier... for primary prevention. These studies are very difficult to do and very expensive, and it could take a decade before we know if they work.. What we really need are biomarkers... ApoE4 genotype plus some other markers (for example, insulin resistance, hypertension, etc)

As someone who is in one of those long clinical trials, I share both the frustration and the hope for more answers--which I think will come before the next decade is up.

Here is an article from last year which has a great pie chart (Figure 2) of the various drugs in the pipeline by category (BACE-1 inhibitor, amyloid immunotherapy, etc.
http://www.sciencedirect.com/science/ar ... 00379#fig2

And for the science nerds who want a little more info, here's a couple of descriptions of immunotherapy and BACE-1.

This is for CAD-106, in the Generations I trial. (The enrollment period is still active, since the study will have a voluntary 3-year extension to continue to monitor participants who choose to continue.)

This is an active vaccination strategy that aims to elicit a strong antibody response while avoiding inflammatory T cell activation... CAD106 combines multiple copies of Aβ1-6 peptide derived from the N-terminal B cell epitope of Aβ, coupled to a Qβ virus-like particle...Phase 2/3 trial began in November 2015 and is set to run until 2023, with a 5-year treatment period. This study aims to enroll 1,340 homozygous ApoE4 carriers between the ages of 60 and 75 who are cognitively normal... As primary outcome, the trial will measure ability to delay diagnosis to MCI or AD dementia and change on the APICC cognitive composite...An extensive list of secondary outcomes include change on the Clinical Dementia Rating Scale sum of boxes (CDR-SB) along with other cognitive/functional scales, fluid biomarkers including CSF Aβ and tau, brain imaging including volumetric MRI plus amyloid PET and tau PET measurement of brain amyloid and tangle deposition, respectively, as well as safety measures and Aβ titers

https://www.alzforum.org/therapeutics/cad106

And here's a brief description of another multi-national drug trial, this one the EARLY trial of a Janssen Company (Johnson & Johnson) BACE-1 inhibitor with Phase 2 clinical trials underway since 2015 in the UK and Europe, and coming soon to numerous sites in the US for people ages 60-85 with Apoe 3/4 or 4/4 and positive amyloid on a PET scan.
[Note: CNP520 in the Generations 1 & 2 trials is also a BACE-1 inhibitor.]

Reduction of Aβ production by inhibition of Beta-amyloid cleaving enzyme (BACE) BACE1 has been proposed as a promising treatment in Alzheimer’s disease (AD), especially when treating early in the disease process. Subjects with prodromal AD (pAD, CDR 0.5) and subjects asymptomatic at risk for developing Alzheimer’s dementia (ARAD, CDR 0) can be identified by positive biomarker patterns ... JNJ-54861911 has been described as a potent oral BACE inhibitor1.

http://www.alzheimersanddementia.com/ar ... 5/abstract
[Emphasis added on quotes.]

Finally, I found 39 trials that are currently active and targeting AD prevention in asymptomatic or MCI individuals. It's too long to link to here, but you can create a similar list if you go to http://www.clinicaltrials.gov and do an "advanced search" for "Alzheimer's" "Active".

Among the studies are ones that are targeting "Curcumin and yoga", the "MIND diet", "Lifestyle interventions for AD", "calorie restriction, insulin resistance and biomarkers", "Fish oil" and "APOE4". If you are interested in those and use the advanced search with those terms, it should help. (Some are very localized--as in Wisconsin only!)