For both patient and caregiver, Alzheimer's disease has been characterized as the disease from Hell, noted William Mino, director of new product management, central nervous system and pulmonary medicine, Sandoz Pharmaceuticals Corp. By the year 2000, he told reporters at a media briefing sponsored by the National Pharmaceutical Council, six million people will be diagnosed with Alzheimer's. The cost to society in 1990 for this disease was upwards of $88 million, he added. (See related article on Alzheimer's disease in the Dec. 14 issue of Drug Topics.)
Mino defined Alzheimer's disease as a type of dementia involving global impairment of intellect or personality without an impairment of consciousness--a multifactorial disease that affects behavioral, cognitive, and quality-of-life issues. Very little is known about the pathophysiology of the disease, he went on, so there is little effective therapy.
Mino related that autopsy of Alzheimer's patients reveals a decrease of acetylcholine in the brain. "There is a problem with the acetylcholine system," he said. But, he added, "it is difficult to say if Alzheimer's is the cause of decreased acetylcholine in the brain or if the decrease in acetylcholine in the brain causes Alzheimer's disease "
Acetylcholine, a prevalent neurotransmitter in the human body, helps the nerve impulses to jump to another nerve or muscle, Mino explained.
According to Mino, Sandoz is currently researching the following four drug compounds for the treatment of Alzheimer's disease:
* SDZ ENA 713
* ENX 792
* SDZ ENS 163
* SDZ 21094
None of the drugs have generic or brand names at this time, he noted.
During a follow-up interview with Drug Topics, Mino explained that SDZ ENA 713 is an acetylcholinesterase inhibitor. Acetylcholin-esterase, he indicated,. is an enzyme that breaks down acetylcholine; inhibiting this enzyme, as in the case of SDZ ENA 713, increases the brain stores of available acetylcholine.
Mino noted that SDZ ENA 713 has just completed phase I clinical trials and is entering phase II trials. The drug has been given orally in doses of up to 6 mg per day and has been well tolerated. Currently, there is a 300-patient study under way in Europe, the researcher disclosed, and mild to moderate adverse reactions--among them digestive disturbances, nausea/vomiting, and dizziness--have been reported with the investigational use of the drug. …