Arjun Masurkar, MD, PhD: New Treatment on the Horizon for Alzheimer Disease

While there have been some major advancements in the last 10 years to help patients manage the symptoms attributed to Alzheimer disease, there has been an elevated push recently to find treatments that can ultimately slow the progression of the disease.

In an interview with MD Magazine®, Arjun Masurkar, MD, PhD, a neurologist and assistant professor in the departments of neurology and neuroscience & psychology at NYU Langone Health, explained why there is some hope finding new treatments for Alzheimer disease.

MD Mag: What drugs are on the horizon to treat Alzheimer disease?

Masurkar: And just to review, the medications that we have right now for Alzheimer’s disease are really for symptoms, treating the symptoms of memory and they've been around for about 15 to 20-years.

They include the cholinesterase inhibitors, donepezil and its 2 sister medications and memantine, which is an NMDA receptor antagonist. Those medications are not disease modifying.

They don't slow down the actual disease. They basically mask the symptoms of memory and so there's been a big quest to find medicines that actually slow the disease down for a while.

And the prime target for these trials has been amyloid. So, Alzheimer’s disease is defined by 2 abnormal proteins, amyloid and tau. By and large most trials have targeted amyloid.

One method has been antibodies to remove amyloid from the brain and there have been newer methods to try to reduce its production in the brain.

MD Mag: Are there any particular advancements that you can point to as the most significant in progression research or treatment of Alzheimer disease?

Masurkar: So overall our approach to the trials themselves have greatly advanced. In the beginning in this field we were recruiting people at the very advanced stages.

We weren't sure if they really had Alzheimer's disease or not. With the advent of in vivo imaging of amyloid, as well as a focus on the very earliest stages of the disease I think we're getting a better handle on what time points we can really take advantage and manipulate the course of disease.

So recently there's been some news about some positive signal and a clinical trial related to an anti-amyloid antibody. This is the Biogen study and what they found was that a particular anti-amyloid antibody, aducanumab, slowed down both cognitive decline and functional decline by about 15-to-20 percent over the course of about 70 odd weeks.

This evidence was from 1 version of the trial and in another trial, it didn't seem to have a statistically significant effect.

Either way they are moving forward with an application to the FDA for approval. But this is very exciting to all of us. We haven't been privy to the data itself, it needs to be vetted by the scientific community as well as the FDA, but either way I think that this lets us know that we are headed in the right direction and that amyloid may actually be a viable target.