Amyloid-based interventions in Alzheimer's disease

Gary J. Kennedy, Todd E. Golde, Pierre N. Tariot, Jeffrey L. Cummings

Research output: Contribution to journalArticle

13 Citations (Scopus)

Abstract

We appear to be on the brink of a new epoch of treatment for Alzheimer's disease. Compelling evidence suggests that Aβ42 secretion is the triggering event in the pathogenesis of Alzheimer's disease, and that tau aggregation may be an important secondary event linked to neurodegeneration. Prophylactic administration of anti-amyloid agents designed to prevent Aβ accumulation in persons with subclinical disease is likely to be more effective than therapeutic interventions in established Alzheimer's disease. Drug development programs in Alzheimer's disease focus primarily on agents with anti-amyloid disease-modifying properties, and many different pharmacologic approaches to reducing amyloid pathology and tauopathy are being studied. Classes of therapeutic modalities currently in advanced-stage clinical trial testing include forms of immunotherapy (active β-amyloid immunoconjugate and human intravenous immunoglobulin), a γ-secretase inhibitor, the selective Aβ42-lowering agent R-flurbiprofen, and the anti-aggregation agent transiposate. Non-traditional dementia therapies such as the HMG-CoA reductase inhibitors (statins), valproate, and lithium are now being assessed for clinical benefit as anti-amyloid disease-modifying treatments. Positive findings of efficacy and safety from clinical studies are necessary but not sufficient to demonstrate that a drug has disease-modifying properties. Definitive proof of disease-modification requires evidence from validated animal models of Alzheimer's disease; rigorously controlled clinical trials showing a significantly improved, stabilized, or slowed rate of decline in cognitive and global function compared to placebo; and prospectively obtained evidence from surrogate biomarkers that the treatment resulted in measurable biological changes associated with the underlying disease process.

Original languageEnglish (US)
Pages (from-to)1-14
Number of pages14
JournalCNS Spectrums
Volume12
Issue numberSUPPL. 1
StatePublished - Jan 2007

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Amyloid
Alzheimer Disease
Hydroxymethylglutaryl-CoA Reductase Inhibitors
Therapeutics
Tauopathies
Immunoconjugates
Flurbiprofen
Active Immunotherapy
Amyloid Precursor Protein Secretases
Intravenous Immunoglobulins
Controlled Clinical Trials
Valproic Acid
Lithium
Pharmaceutical Preparations
Cognition
Dementia
Animal Models
Biomarkers
Placebos
Clinical Trials

ASJC Scopus subject areas

  • Neuropsychology and Physiological Psychology

Cite this

Kennedy, G. J., Golde, T. E., Tariot, P. N., & Cummings, J. L. (2007). Amyloid-based interventions in Alzheimer's disease. CNS Spectrums, 12(SUPPL. 1), 1-14.

Amyloid-based interventions in Alzheimer's disease. / Kennedy, Gary J.; Golde, Todd E.; Tariot, Pierre N.; Cummings, Jeffrey L.

In: CNS Spectrums, Vol. 12, No. SUPPL. 1, 01.2007, p. 1-14.

Research output: Contribution to journalArticle

Kennedy, GJ, Golde, TE, Tariot, PN & Cummings, JL 2007, 'Amyloid-based interventions in Alzheimer's disease', CNS Spectrums, vol. 12, no. SUPPL. 1, pp. 1-14.
Kennedy GJ, Golde TE, Tariot PN, Cummings JL. Amyloid-based interventions in Alzheimer's disease. CNS Spectrums. 2007 Jan;12(SUPPL. 1):1-14.
Kennedy, Gary J. ; Golde, Todd E. ; Tariot, Pierre N. ; Cummings, Jeffrey L. / Amyloid-based interventions in Alzheimer's disease. In: CNS Spectrums. 2007 ; Vol. 12, No. SUPPL. 1. pp. 1-14.
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