Hope for new Alzheimer's drug on the horizon?

What do we know already?

Alzheimer's disease is a serious illness that affects the way the brain works. People in the early stages of the disease can be forgetful, but someone with severe Alzheimer's may fail to recognise their family and friends. Other symptoms can include struggling to talk, to find the right words or even to understand what others are saying. Some people become agitated or depressed.

It can be extremely upsetting for relatives and friends to see someone they love develop Alzheimer's. Although there are treatments, these only bring about small improvements. There is no cure for the disease.

A drug called etanercept was developed in the 1990s to treat rheumatoid arthritis. Doctors are now looking at whether it could be used to help people with Alzheimer's. A pilot study found that injecting it into the back of the neck might help reduce the symptoms of Alzheimer's. Some patients started to improve very soon after the injection, so the researchers have now done a second study to see how quickly someone might see a benefit.

What does the new study say?

The new study looked at just one patient, an 81-year-old man. He'd had Alzheimer's for two years, and tried several drugs, but been unable to take most of them because of side effects. He was taking a drug called galantamine, but without his family or doctor noticing an improvement.

Before treatment with etanercept, the man scored 7 out of 30 on a memory and thinking test. It involved answering simple questions, like giving the date, listing words beginning with a certain letter or naming as many animals as possible in a minute.

The following day, the man was given an injection of etanercept. Within 10 minutes, he appeared calmer and could answer questions more quickly. After two hours, he was given the same memory test as the day before. His score improved to 15 out of 30. A week later, he was still able to score 14 out of 30.

Although the patient did improve, it's important to remember that etanercept is a long way from offering a cure for Alzheimer's. Even after treatment, the man couldn't give the correct date, was only able to think of eight words beginning with the letter F, and only able to list five different animals in the space of a minute.

Where does the study come from?

The study was done by researchers from the Institute for Neurological Research, a private medical company based in Los Angeles, and from the University of Southern California. It appeared in the Journal of Neuroinflammation, published by a company called BioMed Central.

How reliable are the findings?

So far, we can't be sure whether etanercept really reduces the symptoms of Alzheimer's. There have been no good-quality studies comparing it with a dummy treatment (a placebo).

People often feel better after medical treatment, even if they've just been given a sugar pill or a salt-water injection. This is called the placebo effect. Good-quality studies usually compare people getting an active treatment with another group who get a placebo. But this type of study hasn't been done yet for etanercept, so we don't know if it works as a treatment for Alzheimer's.

What does this mean for me?

Although the results of this study are encouraging, it's still too early to say how well this treatment works. We also know very little about the side effects. Etanercept stops your immune system working as well as usual, and people taking it for arthritis have a higher risk of infections, such as tuberculosis.

What should I do now?

If you have a relative with Alzheimer's, it's only natural to be hopeful about new treatments. But etanercept is still experimental, and it's only been tried on a few people with Alzheimer's. For the time being, it's unlikely to be available outside of medical trials.

From:

Tobinick EL, Gross H. Rapid cognitive improvement in Alzheimer's disease following perispinal etanercept administration. Journal of Neuroinflammation. 2008; 5: 2. Available at http://www.jneuroinflammation.com/content/5/1/2 (accessed on 10 January 2008).