With a little help from my friends - Alzheimer's Disease - Susie Boyce

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  • To change this title, go to Notes Master
  • characterized by progressive loss of memory
    and cognitive functions, decline in functional capacity and alteration in behavior.
  • Estimated cost - $300 billion a year in US
    Estimated cost - $1 trillion a year by 2050
    ~57,000.00 per pt with AD per year
    Little long term care
  • Needed to quantify a decline in both neurocognitive ability and in functional ability
  • Finding biomarkers predicting clinical effect
  • These have yet to complete testing and their efficacy proven

    They are aimed at modifying the course of the disease

Transcript

  • 1. Copyright © 2013 Quintiles “With a little help from my friends” The road to a cure for Alzheimer’s Disease Note: This is our personal view not an official company view. Dr Lynne Hughes and Susie Boyce 20 May 2014
  • 2. 2 The Rocky Road of Research in Alzheimer’s Disease 1906: Alois Alzheimer A devastating progressive neurological disease We still do not know the cause The only disease in the top 10 leading causes of death that cannot be prevented, cured or even slowed down.
  • 3. 3 Why is this a problem? This is an increasing global challenge with an aging population Key facts: 2013 World Alzheimer’s Report Global Prevalence of dependency 349 million in 2010 : approx 100m people with dementia 613 million in 2050 : approx 300 - 400m people with dementia 6-8% of all persons older than 65 have AD 30% of population over 85 have AD Requiring Care: • Half of all dementia sufferers • 80% of nursing home patients
  • 4. 4 What is the cost? • Research for AD is lagging behind other diseases - $1 billion/year for heart disease - $500 million/year for AD research • 2012: Prime Ministers Challenge - Improve dementia care and research in 3 years - 60% of people should have a diagnosis & appropriate support cf 30% today - Global collaboration : G8 Dementia Initiative led by the UK - Aim for a cure by 2025 5,000 – 10,000 candidates 12.5 years £1.15 billion 1 medicine Licensing Approval
  • 5. 5 Here comes the science…
  • 6. 6 Where we are Now Treatments are only used after the patient is diagnosed Limited in time and effectiveness On the market for almost 20 years There are only symptomatic treatments available to patients
  • 7. 7 Patient Friendly Scales – local language Trained psychome- tricians The RIGHT Scales 6+ Scales 2 hours of concentration Spouse / Caregiver support How are Treatments Assessed? Patients are treated with the experimental product and followed closely using RATING SCALES Testing is a very subjective, lengthy process requiring concentration. Patients can get tired and confused. The RIGHT Sites
  • 8. 8 Challenges in Drug Development • Very complex disease with uncertain pathophysiology, are we targeting the right abnormality (Amyloid plaques, Tau tangles?) • Long and variable course of disease • Absence of adequate animal models that can be transposed to human forms of disease • Finding the right rating scale as the optimal endpoint (limitation of scales e.g. ADAS-cog)
  • 9. 9 Challenges in Drug Development Complex, Complicated & Costly • Agility in designing and executing the right study (reduce inter-rater variability, reduce placebo response etc.) • Using the right biomarkers • Prove effect on cognitive measures PLUS functional improvement
  • 10. 10 Earlier Diagnosis Challenges for Society • Prodromal AD – before a patient has signs & symptoms of AD • Aged 50+ • Episodic memory problems – where did I leave my keys? • Where are these people? • At home, in the community • No real symptoms • No-one self-identifies with potentially having a disease • How to find them? o Advertising o Digital outreach o Public awareness
  • 11. 11 What does the future hold? GOAL: Treat before the symptoms of the disease appear & prevent the disease developing or progressing. • Intervene earlier at the prodromal stage • We need to identify the patients at an earlier stage of AD – before they progress too far for any therapy to be effective • The new class of drugs called disease modifying drugs (DMDs), mainly targeting the Amyloid Plaque pathway vs Tau pathway • Innovative clinical trial design acceptable for patients, family and regulators
  • 12. 12 Learning and Reflection • Open our minds to change and seize opportunities • Get involved where and when you can • Learn more about dementia friends at www.dementiafrinds.org.uk • For news on dementia visit http://dementiachallenge.dh.gov.uk/ It is complex, it is complicated, and it is costly – hence, we need a little help from our friends Thank you.