Progress in Alzheimer’s Disease: Science, Medicine and Business Coming Together
Solving the Puzzle: Living Longer, Living Well and Reversing the Epidemic of Alzheimer’s and Related Disorders was the title of a lively panel discussion that launched Penn Medicine Advances, a seminar series hosted by the University of Pennsylvania School of Medicine (Penn), last week. The topic is timely—note the publicity generated by the unveiling of the strategic plan by the Alzheimer’s Study Group and the Study Group’s vocal co-chair Newt Gingrich.
NIH’s announcement on an important step in biomarker testing for Alzheimer’s disease, based on levels of amyloid beta42 peptide and tau protein, sparked discussion about the value of testing when today’s Alzheimer’s therapeutics are limited largely to symptomatic relief. Virginia Lee, PhD, director, Center for Neurodegenerative Disease Research at Penn, pointed out that while there are many drugs for Alzheimer’s disease in clinical trials today, biomarkers for assessing disease progress and therapeutic effectiveness are glaringly missing. Biomarkers also have a role in studies to identify risk factors, in particular life style-related risk factors such as obesity and metabolic syndromes, both of which have been implicated in Alzheimer’s disease.
Jason Karlawish, MD, associate professor of Medicine and Medical Ethics, suggested that Alzheimer’s disease may have a different name a few years from now, as medicine increasingly thinks of cognitive impairment or decline as a disability and one that does not have to progress to disease and sequelae. Karlawish used hypertension as an example, where the standard of care today is to treat hypertension rather than wait until progression to kidney failure. But, he also cautioned that while early diagnosis and preventive care are important, they have to be considered “in a way that respects the cost.” This is especially important due to the rising prevalence and societal burden of Alzheimer’s disease. Steve Arnold, MD, director of Penn Memory Center, added that there are several drugs in late phase clinical trials targeting the pathology (e.g., amyloids and tau proteins), and animal studies suggest that early diagnosis and early treatment, ideally before disease onset, will prove the most beneficial. John Trojanowski, MD, director of Penn’s Institute On Aging, noted that pharmacoeconomic models project that a five to seven-year delay of disease onset in the high-risk age groups can dramatically reduce prevalence and thus associated costs—another reminder of the importance of identifying and educating the public about the impact of lifestyle on the disease.
The discussion turned to an emerging model of academia-industry collaboration, where pharmaceutical companies contribute funding for drug discovery programs at Penn in exchange for early access and rights of refusal to discoveries. In many ways, academia offers more research continuity within a naturally multidisciplinary environment and the ability to draw from rich experience and diverse models. Arnold spoke of Penn’s vertical integration from basic research to clinical practice and ethics and societal issues. And, indeed, judging from the audience in the room, with representatives from academia, industry, media and the community, integration is inherent to a disease that touches on so many facets of society.
If you are interested, HBO has a new series, The Alzheimer’s Project: Momentum in Science. Part 1 will air Monday, May 11th at 8pm ET/PT; Part 2 will air on Tuesday, May 12, also at 8pm ET/PT.