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First Alzheimer’s prevention trial begins

The first trial to evaluate whether drug treatments can prevent Alzheimer’s before dementia begins has been launched

September 18, 2013

More than a century after Alzheimer’s disease was first identified, the hard-fought campaign against the disease has reached a potentially significant milestone: launch of the first clinical trials to test whether drug treatments prior to dementia can prevent Alzheimer’s.

The trial is testing two experimental treatments: antibodies known as gantenerumab and solanezumab. It is led by Randall Bateman, MD, the Charles F. and Joanne Knight Distinguished Professor in Neurology at Washington University School of Medicine and principal investigator and director of the Dominantly Inherited Alzheimer Network Trials Unit (DIAN-TU).

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“We plan to test additional preventive treatments in the years to come,” Bateman said. “We believe that the diverse portfolio of drugs and approaches of the DIAN-TU trial will accelerate the discovery of an effective treatment for Alzheimer’s.”

Public and private funding

The trial is funded by a unique mix of private and public resources, including a National Institutes of Health (NIH) grant and the largest Alzheimer’s Association grant ever awarded. Drug manufacturers Roche and Eli Lilly and Co. donated the treatment materials and provided significant financial support. Amyvid Radiopharmaceuticals, a subsidiary of Lilly, supplied a brain-scanning agent called Amyvid, and a company called Cogstate provided a computerized test of cognitive skills.

The DIAN-TU builds upon the research and networking infrastructure established by the NIH-funded Dominantly Inherited Alzheimer’s Network, an international alliance of research centers that investigate the rare forms of Alzheimer disease that are caused by gene mutations. This “parent” DIAN study is directed by John Morris, MD, the Harvey A. and Dorismae Hacker Friedman Distinguished Professor of Neurology at the School of Medicine.

Studying inherited Alzheimer’s

The DIAN-TU prevention trial studies families who have inherited forms of Alzheimer’s, which typically cause dementia at a much earlier age—typically, in the 50s, 40s, or even 30s—than the more common sporadic forms of the disease. An individual who inherits one of the gene mutations typically develops disease symptoms at approximately the same age as did his or her parents.

“Trying to prevent Alzheimer’s symptoms from occurring is a new strategy, but much of what we’ve learned in recent years about Alzheimer’s and the brain has suggested that prevention has a much better chance of succeeding than waiting to treat once cognitive impairment or dementia has occurred,” said Morris, who also directs the Charles F. and Joanne Knight Alzheimer’s Disease Research Center at Washington University. “The courageous participation of family members with these rare forms of the disease makes it possible for us to test this strategy.”

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David Holtzman, MD, Andrew B. and Gretchen P. Jones Professor and head of neurology, is listed on the patent related to the solanezumab antibody that is co-owned by Washington University and Lilly. Washington University has licensed its patent rights to Lilly. The financial interests of the university and Holtzman in this patent are managed in accordance with applicable conflict-of-interest policies and regulations.