In the four minutes it takes to read this post, the United States will spend more than a million dollars combatting Alzheimer’s disease. Two Americans will develop the disorder. And six caregivers will join a loved one in a battle against a relentless and devastating foe.
Unfortunately, there are currently a lot more statistics that describe the challenges posed by Alzheimer’s disease than validated solutions to defeat it.
It’s the tau, it’s the amyloid beta, it’s the immune system, it’s non-genetic risk factors, it’s a lack of sleep… If you ask five Alzheimer’s researchers their opinion on the root cause of the disease, you’re likely to get seven opinions in return. That’s because Alzheimer’s is a disorder that is practically unrivaled in its complexity. With elements of aging, genetic proclivity, and lifestyle possibly playing a developmental role, and with multiple neurotransmitter systems and cellular neurodegeneration both involved, we’re still in the midst of a long, hard fight to simply understand our opponent.
This complexity may explain why only four of 123 Alzheimer’s drugs that went through clinical testing between 1998 and 2014 received FDA approval, and why many drugmakers quietly abandoned the search for better solutions.
But I see this area not as a quagmire, but an opportunity. Those of us working in Alzheimer’s have the unique prospect of making a large difference for an enormous number of people currently living with Alzheimer’s and for tens of millions more who will develop it during our lifetime. It may be the defining medical challenge of our age.
At Lundbeck, we have been waging this war for decades, giving us a unique perspective on the road ahead. Experience has guided us to three principles that will gird any success in Alzheimer’s:
- Our approach must be public-private. While many companies have abandoned drug development for brain disorders because of its associated cost, complexity, and high failure rates, for those of us who have persevered, the only way to be effective is to gain strength in numbers. This means collaborating shoulder to shoulder with government, academic and industry researchers. For instance, last year Lundbeck joined forces with seven universities and Janssen Pharmaceuticals, with significant funding from The Wellcome Trust, to better understand the novel link between the immune system, neuroinflammation, and brain disorders, especially Alzheimer’s and depression. This is one example of the numerous partnerships we have entered in our joint fight against this disease. Looking towards the future, when it comes to basic research and early drug development, I am more and more certain these types of collaborations are essential to success.
- We must continue to advance symptomatic treatments. When disease epidemics arise, our natural impulse is to focus all our energy on developing a cure. Obviously, I share this ambition, and truly believe that with a focused, well-resourced and collaborative effort, we will ultimately succeed; we have an early stage research program that aims to do just that. However, our desire to develop a true cure shouldn't obscure our focus on treatments that improve daily life. The reality is, most disease-modifying compounds currently in development have the potential to delay the progress of Alzheimer’s rather than prevent it entirely, which actually extends the window during which symptomatic treatments serve as critical tools. While it’s tempting to fixate only on those compounds that have disease modifying potential, from the perspective of patients and caregivers, therapies that offer symptomatic improvement can serve as huge breakthroughs.
- We must diagnose the disease earlier. In the same vein, while developing a true Alzheimer’s cure remains our ultimate goal, the significant burden of Alzheimer’s confronts us here and now. So while we must remain vigilant in developing a cure, we have to be equally committed to identifying and treating the disease in its earlier stages when we have the best chance to control its course.
Tackling Alzheimer’s is going to require a monumental effort over the coming years, but I am hard-pressed to think of a single area of medicine currently requiring more attention. I hope that as we move forward, we continue to see more focus paid to this devastating disease.