Alzheimer's Research Charity
UK - France - Europe
BREAKING NEWS
21 November 2024
Death of John Prescott
The death of John Leslie Prescott aged 86 years on 20 November 2024, was reported today. He was born in Flintshire and a chance meeting with Sir Anthony Eaden whilst working as a ship’s waiter fired his interest in politics. Following a Labour landside victory in 1997 he established the Kyoto submit on climate change which secured international agreement on limiting greenhouse gases. He was the longest serving Deputy Prime Minister and respected across the parties as an innovator and a direct communicator of contentious issues.
He suffered a stroke in 2018 and later from Alzheimer’s disease. His battle with Alzheimer’s led to his commitment to medical research.
20 November 2024
Only 4 months ago, the European Medicines Agency (EMA) rejected a marketing authorisation
application for the monocloncal antibody, Lecanemab as a treatment for Alzheimer’s disease
on the grounds that the risk of adverse bleeding in the brain exceeded potential clinical benefits.
For reasons which remain unclear, the EMA has just reversed its July decision to now recommend
a marketing authorisation for Lecanemab in all European countries albeit with some cautionary
restrictions. Its recently published report does not refer to any new clinical trial data under-
pinning this change of position thus the assumption is that the Agency’s ‘about turn’ was
influenced by pharmaceutical lobbying or by patient groups either of which would have raised
the fact that marketing authorisations having been granted already within other countries such as the USA, Japan, China, UK and elsewhere.
Risks of serious adverse effects weighed against potential benefits is always at the heart of any medicines licencing decision. Published clinical trial data has reported a 27% reduction of clinical decline using the monoclonal antibody, amyloid drug Lecanemab. Amyloid is a protein found in the brain which forms an aberrant form known as beta amyloid with aging and in particular, in Alzheimer’s disease. Beta amyloid associates itself with a cell type in the brain called neurons and there is some clinical data which correlates the presence of amyloid plaques with cognitive decline through the loss of neurons. It is a complex picture and one which is subject of scientific research.
Lecanemab targets amyloid plaques but when clearing the dissipated protein from the brain, an inflammatory reaction damaging to the brain’s blood vessels can be triggered Such bleeding in the brain is a serious adverse effect which in itself can lead to death or severe cognitive dysfunction - the symptoms depending on the region of the brain damaged.
It remains a decision for the UK’s Medicines and Healthcare Regulatory Agency to recommend or otherwise the use of Lecanemab for treatment in early stage Alzheimer’s disease and given current concerns of serious adverse effects it will be a controversial decision.
Reversal of decision by the European Medical Agency to recommend the marketing authorisation of Lecanemab in Europe
10 November 2024
CTAD2024 : Clinical Trials in Alzheimer’s Disease Conference
(29 October - 1 November 2024 ; Madrid, Spain).
Earlier this month, I attended the Clinical Trials in Alzheimer’s Disease conference along with fellow Trustee Professor Colin Masters. Over the three-day meeting, data was presented on the safety and efficacy of new drugs being trialled as well as enhanced studies using monoclonal antibodies with Lecanemab (licenced in the UK) being one of these.
As with any disease, it is common knowledge that early diagnosis opens the door to drug treatment aimed to slow disease progression including the development of the pathology, cognitive decline and accompanying psychiatric symptoms. Data assessing the reliability of several bio-markers for the early diagnosis based on forms of the aberrant tau protein (tau fibrils being a pathological hallmark of Alzheimer’s disease).
With the majority of conference speakers coming from the pharmaceutical and biotechnology industries it was inevitable that trial data concerning pipeline drug treatments were cautiously explained. Monoclonal antibodies appear to remain the most favoured of current and potential disease-modifying treatments albeit with some safety concerns.
Here is a schematic presentation of the range of drugs of different classes and with different targets currently in phase III development presented by Jeffrey Cummings, as previously published in Alzheimer’s Dementia (NY) 2024 April 24:10(2)e 12465:doi:10.1002/trc2.12465
Dr. Sarah-Jane Richards, Chief Executive
While biomarkers detected in blood is a valuable step forward for early diagnosis, the reliability of current bio-markers is variable and herein lies one of the many challenges for developing such diagnostic markers. Early presentation of the disease can be extremely variable between individuals which can compromise the desired homogeneity (and hence reduce the power) of any clinical trial group. Pre-trial, genetic screening can reduce some of these variables, in particular known inherited mutations. Nevertheless, gender, ethnicity, age of onset, and comorbidities are just a few other factors which can influence the onset of the disease, its profile and trial outcome. While clinical trials reported sought to minimise variation between groups, inevitably these differences between individuals add a level of complication to data interpretation. Interestingly, it was reported that at autopsy, some control individuals had a pathology profile indicative of Alzheimer’s disease while remaining asymptomatic throughout the study while others had a positive diagnosis via standard cognitive testing without a significant pathology observed at autopsy. While such conundrums currently defy explanation, they remain a headache for clinical trial design.
It was also noteworthy that the development of biomarkers for the aberrant amyloid protein were significantly fewer from those detecting tau. There was no clear explanation for this and perhaps we will see more biomarkers targeting the other pathological protein, beta-amyloid in the future.
8 November 2024
Death of June Spencer, aka Peggy Archer
Being a keen listener of the BBC radio series The Archers over several decades, it was sad to hear of the death of Ambridge matriarch, Peggy Archer played by June Spencer. Amazingly she continued in that role from 1951 until she retired in 2022 at the age of 103 years.
Peggy was noted for her devotion to fictional husband, Jack Woolley – an Alzheimer’s disease sufferer. Her sympathetic but bluntly honest portrayal of Jack’s cognitive decline undoubtedly raised awareness of the difficult management decisions regarding care of Alzheimer’s disease sufferers and the devasting effect such decisions have on the carer. The storyline highlighted so poignantly the need to identify treatments or a cure for this dreadful disease. No listener could have failed to have been moved by this heart-breaking story which did so much for increasing awareness of Alzheimer’s.
June was a family favourite who will be deeply missed and who so accurately portrayed the ups and downs of living with a spouse suffering from dementia. June died on 8 November at the age of 105 years. In 2017 she was awarded the Commander of the Order of the Brish Empire for services to drama and charity.
August 2024
Latest drug update
This month, the drug Lecanemab has been approved by the Medicines and Healthcare Products Regulatory Agency (MHRA) for use in the UK for those suffering from early Alzheimer’s disease.
The National Institute for Clinical Excellence (NICE) has not recommended the
prescription of Lecanemab due to significant costs not only of the drug itself
but also of the requirement for regular neuro-imaging monitoring at a time
when the NHS is struggling to cope.
This announcement will mean that Lecanemab will be, in the most part, only available to patients who can afford to pay for the drug and the follow-up monitoring required. Although enormously disappointing for those who have received an early diagnosis, it does provide a real basis for hope of the development of further new generation, effective and safe drugs to slow the development of Alzheimer’s disease.
Research into vaccines is progressing in parallel, to prevent the development of the pathology itself.
Our readers may recall the withdrawal of Tacrine - a cholinesterase inhibitor in 2013 after it was found to have hepatotoxic effects. Tacrine was the first drug approved by the Federal Drug Agency (FDA) in 1993 for the treatment of Alzheimer's disease. New Tacrine derivatives are also currently being investigated with the aim of amplifying efficacy whilst reducing toxicity.
22 July 2024
Alzheimer's Research Charity (France)
The international branch of the charity is registered under French law as a recognised (and regulated) association.
The trustees and friends of Alzheimer's Research Charity (France) are active in supporting research bringing together scientists and facilities in both UK and France.
January 2024
Charity welcomes Jacqueline Perry KC to be its Chairman.
Jacqueline is an experienced barrister and King’s Counsel who practises law in both California and the UK. She qualified in the UK in 1975 and became Queen’s Counsel in 2006.
In recent years, Jacqueline she has advised on many substantial and highly publicised cases and successfully pioneered arguments and points of law or practice. She says “Alzheimer’s disease in one of the greatest challenges to those approaching retirement and beyond. The disease has an insidious onset of symptoms commonly described as ‘forgetfulness’ or ‘brain fog’ but which may relentlessly develop to the point where individuals affected no longer recognise the people, events and values which for years has defined them as who they are. A fearfulness of surroundings and even those close to them is so often sadly noted by family and friends. I whole heartedly support the Campaign for Alzheimer’s Research as I believe it is only through investment in research that we will discover the key to treatment and disease prevention.”
January 2024
Professor Philippe Hantraye is welcomed to the Board of Trustees
Philippe is the recently retired Director of MIRCen (Molecular Imaging Research Center), a research laboratory of the French atomic commission (CEA), dedicated to the design, testing and validation of drug, cell and gene-based therapies for neurodegenerative disorders within his specialism of neuro-imaging.
He is also the Scientific Director of the large Infrastructure for Translational Neurosciences - NeurATRIS which harnesses scientific discovery from seven hospitals and institutes in the Paris region of France. Combined, they provide multidisciplinary expertise in researching Alzheimer’s disease and other neurodegenerative disease from cell culture through to phase II clinical trials.
