26 January 2008

Arthritis drug Etanercept tested on patient with Alzheimer’s disease

‘Instant’ Alzheimer’s drug claim
NHS Headlines: 10 January 2008
“A drug used for arthritis can reverse the symptoms of Alzheimer’s ‘in minutes’”, the Daily Mail reported. Several newspapers covered the story of how an 81-year-old man with Alzheimer’s disease improved within 10 minutes of being injected with a new drug, etanercept. The BBC reported that his wife described the effect on her husband as being “put back to where he was”. His son said, “This was the single most remarkable thing I’ve seen”…. > full story : teaching brief : comments from AlzForum

Alzheimer’s Australia Research Officer, Suzanne Dixon comments: There has been a lot of commotion recently over the reported ability of the rheumatoid arthritis drug Etanercept (marketed as Enbrel by Amgen Inc and Wyeth) to 'reverse' symptoms of Alzheimer's disease within 10 minutes when injected by spinal infusion. After injection, the 81-year-old patient in the Californian study demonstrated progress on cognitive tests within ten minutes, marked improvement in two hours, and continued therapeutic benefit upon further treatment over a period of several weeks. Effects appeared to take the form of specific memory recall, as well as increased calmness and attentiveness. Etanercept acts to neutralise Tumour Necrosis Factor ? (TNF-?), which is a signalling protein involved in inflammation and used in the brain for correct synapse function. The drug may prevent excess TNF-? in the brain from either: causing inflammation that can lead to amyloid-beta build-up; or interfering with correct neural regulation, which results in synapse impairment and development of Alzheimer's disease.

It is important to remember this is an isolated case study. There have been several other individuals who have demonstrated improvement on this treatment, but as yet there have been no clinical trials, no controls, and no physical markers of Alzheimer's disease examined in any of the reports. In this case the patient, doctor, and family were all aware of the treatment, implicating a possible placebo effect. The improvement was also limited: for instance, although the patient could subsequently locate himself geographically, he still got the year wrong. There was no significant follow-up to determine the longevity of the improvement, and there have been no safety tests of the treatment or its delivery method. Although this study may ultimately point the way towards Alzheimer's research into TNF-? blockers, it really is too early to draw any strong conclusions about the drug based on the research performed.

updated: 27 January 2008

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