Why are african americans and hispanics more likely to be diagnosed? Treatment most effective in preclinical or prodromal stage, highlites the importance of biomarkers
Transcript of "Alzheimer's Presentation "
Alzheimer’s ProposalBACKGROUNDPresented by Stefan Marcus
Alzheimer’s DiseaseDementia – Impairment in cognitive function which is significant enough to interfere with daily activities Most common dementia Loss of neuron function and degeneration of the brain Deficiencies in neurotransmitters Exact causes unknown Changes in the brain: beta-amyloid build up and tau tangles Known cause: Genetic mutation (<1% cases)
Progression and DiagnosisProgression Diagnosis - primary caregiver New guidelines as of 2011 Variety of symptoms such as memory loss, personality New stages changes, and physical Biomarkers (protein levels in impairments blood, for example)1984 1. Beta-amyloid in the brain 2. Extent of neuron damage2011 Timely diagnosis is crucial Preventative approach (active care)
TreatmentPharmacological NMDA Ligand – Binds to glutamate receptors to prevent overstimulation Acetylcholinesterase Inhibitors – Maintain acetylcholine levels by preventing enzyme hydrolysis FDA APPROVED No cure, only palliative treatments currently availableTotal Sales: 7 billion USD (2009)
Future Developments Potential: Disease modifying drugs (Anti-beta-amyloid antibodies) Acetylcholine esterase inhibitors and memantine facing patent loss and generic competition Indication Preclinical Phase I Phase II Phase III Pending approval Alzheimer’s 92 59 57 3 11 Global Alzheimer’s Development Pipeline (2009) Validating and quantifying biomarkers (gold standard) Prodromal standardization and asymptomatic characterization Studies on the effect of diet, exercise, previous ailments
Alzheimer’s in the US (2012 and beyond)Prevalence Incidence Increases with age 5.4 million affected in (2012) BUT under diagnosed Number of cases projected to double by 2050 2/3 are women Economic Burden Aggregate Cost of Care by Payers for Alzheimer’s Patients over 65 Forecast: $1.1 trillion in 2050 Percentage of People With Delaying long-term care could save Alzheimers by Age Group millions of dollars
Summary Debilitating disease with no cure Major cause of death for elderly Americans Socioeconomic drain What is needed? Understanding pathology of disease to develop new classes of drugs Clinically integrated early diagnosis methods Evidence on prevention measures
ReferencesAlzheimer’s Association, 2012. 2012 Alzheimer’s Disease Facts and Figures.Business Insights, 2011. Advances in Alzheimer’s Disease Drug Discovery. , (May).Business Insights, 2010. The Market Outlook for Neurodegenerative Diseases. , (September).Forsyth, E. & Ritzline, P.D., 1998. An overview of the etiology, diagnosis, and treatment of Alzheimer disease. Physical therapy, 78(12), pp.1325–31. Available at: http://www.ncbi.nlm.nih.gov/pubmed/9859951.Hampel, H. et al., 2011. The future of Alzheimer’s disease: the next 10 years. Progress in neurobiology, 95(4), pp.718–28. Available at: http://www.ncbi.nlm.nih.gov/pubmed/22137045 [Accessed July 18, 2012].Herrmann, N. et al., 2011. Current and Emerging Drug Treatment Options for Alzheimer’s Disease: A Systematic Review. Drugs. Available at: http://www.ingentaconnect.com/content/adis/dgs/2011/00000071/00000015/art00006 [Accessed September 23, 2012].