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'Alzheimer's drug halts decline'

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What did the media report?

The media reported that an experimental Alzheimer’s drug could slow cognitive decline by 81%, performing twice as well in trials as any existing treatment.

What did the research show?

The reports are based on results from a phase II trial of methylthioninium chloride (MTC), a drug that targets tau protein and its aggregation into ‘tangles’ in the brain.

These tangles are characteristic hallmark of Alzheimer’s disease and appear before clinically apparent symptoms of dementia. The tangles first destroy nerve cells critical for memory and then destroy neurons in other parts of the brain.

MTC is an alternative to anti-amyloid therapies for Alzheimer’s and has been shown in the test tube to dissolve tau tangle filaments.

Researchers investigated the effects of oral MTC at 30, 60 and 100mg doses three times per day, compared with placebo, on cognitive function in 321 patients with mild or moderate Alzheimer’s.

Patients receiving the study treatment experienced an 81% reduction in cognitive decline over one year, and did not experience a significant decline in their mental function over 19 months.

The decline seen in patients treated with MTC was not significantly different from their starting score to the assessment at one year and at their final assessment at 19 months. In the control group, there was a significant decline from the starting score in cognitive testing and on brain scans. There were statistically significant differences between the patients receiving the study drug and the controls at 24 and 50 weeks.

The research was a collaboration between Aberdeen University and TauRx Therapeutics. The findings were presented last month at the International Conference on Alzheimer’s Disease 2008 in Chicago.

What did the researchers say?

Lead researcher Claude Wischik, chairperson of TauRx Therapeutics and professor of psychiatric geratology and old age psychiatry at Aberdeen University, said: ‘This is an unprecedented result in the treatment of Alzheimer’s disease. We have demonstrated for the first time that it may possible to arrest the progression of this disease by targeting the tangles which are highly correlated with the disease.

‘This is the most significant development in the treatment of the tangles since Alois Alzheimer discovered them in 1907,’ he said.

‘I am delighted with these results. This is the first trial of an Alzheimer’s disease modifying drug which actually hit its primary pre-specified efficacy target.’

What does this mean for nursing practise?

Professor Clive Ballard, director of research at the Alzheimer's Society, said: ‘This is a major new development in the fight against dementia. It is the first realistic evidence that a new drug can slow cognition decline in people with Alzheimer’s, by targeting the protein tangles that cause brain cell death.

‘This first modestly sized trial in humans is potentially exciting. It suggests the drug could be over twice as effective as any treatment that is currently available,’ he added.
‘However we are not there yet. Larger scale trials are now needed to confirm the safety of this drug and establish how far it could benefit the thousands of people living with this devastating disease.’

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