Magazine article Drug Topics

First-Ever Alzheimer's Drug Brings Some Hope to Millions

Magazine article Drug Topics

First-Ever Alzheimer's Drug Brings Some Hope to Millions

Article excerpt

For the first time, a new drug has been approved for the treatment of patients with Alzheimer's disease. Called Cognex (tacrine HC1), it will be marketed by the ParkeDavis division of Warner-Lambert Co.

Some four million people in the United States suffer from Alzheimer's, Paul Solomon, professor of psychology and chairman of the neuroscience program at Williams College, told Drug Topics. The financial cost of caring for patients last year, he added, was $100 billion.

The United States is experiencing an "octaboom," Solomon a said, with the fastest growing segment of the population represented by those over age 85. "We're expecting by the year 2050, if we're not successful in doing something, 14 million to 15 million cases of Alzheimer's disease," he added. "It's going to reach epidemic proportions."

The disorder gradually chips away at the memory, leaving patients progressively more confused and disoriented. The capacities for learning and communicating dwindle. Ultimately, routine tasks become impossible to accomplish.

STILL A MYSTERY.

Though much about Alzheimer's remains a mystery, one finding is that patients have dramatically reduced levels of certain neurotransmitters, particularly acetylcholine. Cognex, which is indicated for those with mild to moderate disease, appears to boost levels of the chemical messenger by inhibiting cholinesterase, an enzyme that normally breaks it down.

However, because the drug is designed only to prolong the action of available acetylcholine, it is believed that it may become less useful as the disease progresses and the nerve cells that manufacture ACH continue to wither. In order for Cognex to have some effect, "there can't be total degeneration of those cells," Solomon pointed out.

"This drug is not a cure for Alzheimer's disease," he continued. "It has the potential, in some patients, to improve symptoms or to keep symptoms from deteriorating in a way that makes a meaning difference to them. It allows them to maintain their lifestyles for longer periods of time."

In this case, "efficacy" should not be characterized as "improvement," Solomon said. "The natural course in Alzheimer's disease is for a deterioration over time," he explained. "In the six months that we studied the drug, we saw many patients who did not deteriorate. And we did see slight improvement in some patients.

"But," Solomon went on, "I think we have to characterize the improvement as minimal. …

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