By Angela Woodall, Healthcare and Environmental Reporter.

Behind the outward cognitive warning signs of Alzheimer’s disease — decline in memory, thinking and reasoning skills — is a build-up of abnormal protein deposits that cause brain cells to die. When Biogen and Eisai Co., Ltd. In July announced additional Phase II clinical trial results of BAN2401, a therapy meant to tackle this process, onlookers responded with optimism despite several caveats.

The team reported that while the study had missed its primary endpoint, BAN2401 showed success in reducing amyloid, the source of harmful fibrous deposits,and slowed cognitive decline.

The findingsrepresented the second Alzheimer’s clinical trial to demonstrate a combination of clearance of amyloid from the brain and cognitive benefits, according to Eisai’s Lynn Kramer. “We view this as robust enough to approach regulatory authorities to discuss next steps in terms of additional trials or even breakthrough status,” she said, shortly before presenting the results at the Alzheimer’s Association International Conference 2018, one of two platforms preceding World Alzheimer’s Day on September 21st.

Going on nearly a quarter of a century, World Alzheimer’s Day marks the pinnacle of an entire month dedicated to raising awareness about Alzheimer’s and dementia. Outreach strategies range from Twitter hashtags to symposia and research reports. But the goal is to give advocates the opportunity to build on a particular theme each year for the entire month of September while emphasizing that Alzheimer’s disease is the most common form of dementia, a group of disorders that affects mental functioning among tens of millions of adults worldwide.

Whereas this year’s “Every 3 Seconds” theme featured the pervasiveness of the disease, precision medicine was the fulcrum around which the second event, the Alzheimer’s Disease Research Summit 2018, revolved. The National Institute on Aging has convened the summitevery three years since its inauguration in 2012 in order to build on the agenda set out in the National Plan to Address Alzheimer’s Disease.

The capstone goal of the 2012 National Plan is to prevent and effectively treat Alzheimer’s disease by 2025. The goals of this year’s research agenda were characterized by a multidisciplinary approach designed to support precision medicine, interventions that address the underlying disease process, as well as the disease symptoms and are tailored to a person’s unique disease risk profile. Not surprisingly, given the exploratory nature of precision medicine, the summit’s programmatic themes revolved around understanding disease heterogeneity,  enhancing research rigor, reproducibility, and translatability, as well as enabling “rapid translational learning through open science systems and incentives.”

However, anyone looking for hints about trends in clinical trials could find multiple research tracts. The National Institute on Aging alone supports more than 170 different drug trials and research studies, including drugs that target the core biology of aging.Eliezer Masliah, the NIA’s director of the division of neuroscience, told reporters that the opening of different approaches gives him hope.Meanwhile, lifestyle and genetics remain significant areas of investigation.

Funding to pay for these diverse lines of inquiry continues to rank high on the agenda. On the federal side, research dollars reached $1.9 billion in 2018. In the private sector, a group of philanthropists including Bill Gates announced a $30 million accelerator fund to support the development of new Alzheimer’s diagnostic kit that would use a blood test to diagnose Alzheimer’s and track the disease and any treatment. In the middle are collaborations between public, private and nonprofit organizations.

With the optimism that the proliferation of studies is generating concern over unrealistic hopes for a cure. This particular vein of cautious optimism might have been best summed up by the director of the Memory and Aging Program at Butler Hospital: “There have been plenty of disappointments, and sadly, I’m an expert in those disappointments,” he said. And yet, he added, “I’m quite bullish and think we’re making significant progress.”

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