A year ago I wrote a blog about the great accomplishments happening in Alzheimer’s Disease (AD) research, which were highlighted at the 2016 Alzheimer’s Association International Conference (AAIC). After years of failed trials and frustrating dead ends, we have begun to see results, including advances in the understanding tau pathology and the ability to conduct tau imaging in live patients.
A year later, progress continues at a rapid clip, as we continue to expand our understanding of tauopathy, neurotoxicity of tau in the brain, and other factors in this disease.
For a long time we believed that beta amyloid plaque was the sole driver of AD symptoms, however, recent studies suggest tau protein may be the real driver, or at least an accomplice in this disease. These insights are due in part to more sophisticated tau imaging to show correlations between the spread of tau and cognitive declines. In 2016, for example, scientists from Washington University in St. Louis published results of a study showing Tau deposition in the temporal lobe more closely tracked dementia status and was a better predictor of cognitive performance than beta amyloid deposition in any region of the brain. Similarly, scientists from the University of California, Berkeley, conducted a study used the tau PET ligand AV1451 to reveal an age-related accumulation of tau in the medial temporal lobe in healthy older adults that tracks with weakening episodic memory.
These studies and the resulting knowledge open the possibility for better diagnosis and treatment of AD and other neurodegenerative diseases, including the development of anti-tau targeted therapies. Several companies are already developing tau biomarkers, and validating them in post mortem studies.
Many of these themes are currently being covered at the 2017 AAIC conference, which began July 14 and runs through the week.
Every year, AAIC brings together the world’s leading AD researchers, investigators, clinicians and the care research community to share discoveries and brainstorm new directions to take AD research. This year’s event has many presentations covering the field of amyloid and tau imaging, and discussions exploring opportunities to potentially reduce the presence of tau as a therapeutic option.
Friday’s workshops, for example, included a course on Neuroimaging in Dementia, and The Basics of Fluid Biomarkers in Alzheimer's Disease; while Sunday’s emerging concept session focused on The elimination of amyloid-beta from the brain, and how measuring the concentration of different proteins in the cerebrospinal fluid forms the basis of a CSF biomarker.
Big data and AD
Another one event I am particularly excited about is Simon Lovestone’s talk on Tuesday about The Future of Electronic Health Records and Big Data in Dementia Research.
With the recent merger between Quintiles and IMS Health, my colleagues are at the forefront of using advanced data analytics tools and access to global healthcare data to disease research. In our AD collaborations, we are mining electronic health records and other global data sources to conduct predictive analytics that help our partners select clinical trial sites, identify patient pools, and build referral networks of physicians to speed their AD trials. This is particularly important for AD research as most current trials focus on early stage patients who may be asymptomatic and thus difficult to diagnose and recruit.
QuintilesIMS is also the only CRO participating in the European Prevention of Alzheimer's Disease Consortium (EPAD), which is working to identify thousands of patients in the EU with prodromal AD and at risk for Alzheimer’s dementia, and funnel them into an adaptive trial where multiple biopharma companies can test and compare drugs in order to streamline the discovery process. The goal of the program is to deliver innovative treatment solutions to market faster and more cost effectively than ever before.
Along with attending these sessions, I look forward the many conversations I will have at AAIC with world-class researchers working to develop new diagnostic tools and treatments to fight this terrible disease. It is one of the most powerful events of the year for the AD community, and I feel privileged to be a part of it.