Alzheimer’s never takes a break, so neither can we

Alzheimer’s disease is a progressive and irreversible neurodegenerative disorder that is the leading cause of cognitive impairment and dementia globally. Dementia leads to gradual intellectual decline and changes in mental stability, which are related to reduced autonomy of patients. The disease has a significant impact on patients’ life expectancy and quality of life. Alzheimer’s disease is characterized by the accumulation of beta-amyloid peptides and pathological forms of tau proteins in the brain, which lead to nerve cell damage and neuronal death. Current therapy provides palliative care and control of worsening symptoms despite not providing significant efficacy.

A share of research efforts has concentrated on the clinical development of disease-modifying agents targeting the pathological features of Alzheimer’s disease in the brain. The disease-modifying therapy aims to inhibit the formation of beta-amyloid and tau protein plaques in the central nervous system to mitigate cell death and disease progression.

Several therapeutic approaches are under development: beta-amyloid immunotherapy using antibodies, active immunotherapy using vaccines, passive targeted monoclonal antibody therapy, and stem cell therapy. Beta-amyloid immunotherapy would ensure the destruction and removing of the amyloid plaques formed in the brain. Active immunotherapy, which is realized by the application of vaccines, will contribute to stimulating the production of neutralizing antibodies against the plaque-causing beta-amyloid. Passive, targeted monoclonal antibody therapy is also directed towards the accumulation of beta-amyloid in the brain. Stem cell therapy aims to replace the damaged tissues, contributing to neuron regeneration and improvement of cognitive capacity.

The success of the therapeutic approach depends on the possibility of detecting the disease in early preclinical and pre-dementia stages when the benefits of the treatment will be most significant. Moreover, establishing corroborated biomarkers will ensure early diagnosis and initiation of personalized therapy. Over 115 potential treatments are currently in clinical development, of which 75% are disease-modifying therapies. The majority of clinical trials for Alzheimer’s disease treatments are in Phase I or II. However, numerous assets in Phase III promise the introduction of innovative therapy in the next 3-5 years.

Alzheimer’s disease: What potential breakthrough are we awaiting?

Disease-modifying therapy will preserve and restore the cognitive capacity of patients. This approach will allow active participation in social interactions and professional activities. In this manner, the innovative therapy will improve economic productivity and patients’ independence on healthcare.

How will this approach help the patients?

Alzheimer’s disease leads to progressive cognitive decline, which impairs participation in daily living and professional activities. Deterioration in physical and mental health requires long-term treatment and high expenditure on public resources, which puts a large burden on the healthcare system. As the severity of Alzheimer’s disease increases, the therapeutic approach requires effective treatment of co-morbidities and symptomatic therapy. Disease-modifying therapy will preserve cognitive functions and social interactions with relatives. In this way, an opportunity for better patient collaboration will be provided, in order to ensure an effective multidisciplinary therapeutic approach and personalized therapy.

How many patients will be concerned?

Alzheimer’s disease is the most common cause of dementia and one of the most significant public health issues in the European Union. The number of cases in Europe is around 7,9 million and will increase because of the significant aging of the population. It is estimated that by 2050 the number of patients with Alzheimer’s disease will reach 18,8 million. In Bulgaria, the number of cases exceeds 108 thousand. Disease-modifying therapy will provide sustainable and long-term perseveration of patients’ autonomy. This approach will contribute to improved social interactions and professional engagement. In this manner, the socio-economic burden on relatives and society will be alleviated. Alzheimer’s disease leads to behavioral and psychological conditions which have a negative impact on family relations and economic productivity. Disease-modifying therapy will slow down the decline in physical health and cognitive capacity, which will contribute to improved quality of life and financial independence.

What will be the potential impact on healthcare systems in Europe?

Disease-modifying therapy will alleviate the burden on the healthcare system by providing a more effective allocation of healthcare resources and easier access to healthcare services. This approach will ensure improved quality of life and working conditions for caregivers. Slowing down the progression of the disease and the restoration of cognitive capacity will diminish the dependency on healthcare. In this manner, the expenditure on symptomatic therapy and treatment for co-morbidities will be reduced.

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DISCLAIMER

The therapies described above are currently under development and are not available to patients neither in Europe, nor in Bulgaria.