Drug Promising For Advanced Alzheimer's

An experimental treatment for Alzheimer's may allow treatment at a later stage than other medications, but some experts question the drug's benefits.

The drug, known as Memantine, has been on the market for a decade in Germany and was recently recommended for approval by the European Union's equivalent of the Food and Drug Administration.

Memantine works through a different mechanism than other, currently approved Alzheimer's drugs, such as Aricept, that have been shown to affect progression of early stage disease. The final devastating period, where Memantine may help, can also be the disease's most long lasting.

According to the Alzheimer's Association, four million Americans suffer from the disease, and there a currently no approved treatments for moderate to severe stages of the disease, when patients can start to lose the ability to care for themselves.

But researchers found that Alzheimer's patients who received Memantine deteriorated mentally at a considerably lower rate than patients who received placebo, according to results of a recent large nation-wide Memantine study presented last month at the meeting of the American Association for Geriatric Psychiatry in Orlando, Fla.

"Patients deteriorated one-half to one-third as far as they otherwise would have," says Dr. Barry Reisberg, principal investigator of the study and clinical director of the William and Silvia Silverstein Aging and Dementia Research Center at the New York University School of Medicine. Additionally, the drug was found to be safe and well tolerated.

Rethinking Expectations

While some are calling it a significant advance in the treatment of Alzheimer's disease, others remain much more cautious about the drug's potential and how it's benefits could be misinterpreted.

"It is safe to say that memantine brings no real 'quantum leap' in Alzheimer's treatment," says Dr. Sam Gandy, director of the Farber Institute for Neurosciences at Thomas Jefferson University in Philadelphia, Pa. "These drugs are aimed at symptoms — at later changes — they are not aimed at the cause of the disease."

Others have also questioned why anyone would want to slow the rate of decline or maintain someone at an advanced stage of disease — seeing it only as a means of prolonging the inevitable.

Yet while experts say these benefits were small, they believe the slowed deterioration can have a big impact. People needn't expect a return to pre-disease functioning in order to accept a new drug.

"If you can hold [patients] off and keep them from getting worse for a long time, that's a huge benefit," says Dr. Rachelle Doody, Effie Marie Cain Professor in Alzheimer's Disease Research at the Alzheimer's Disease Center at Baylor College of Medicine in Houston, Texas, who also participated in the Memantine trial. "You can have some really important preservation of functions even in people who are severe."

Slowing the rate of decline at advanced stages can mean that someone may retain the ability to dress or bathe themselves or retain continence for longer periods of time. These gains can improve quality of life for the patient as well as the caregiver.

"Only about 20 percent of our patients in our Alzheimer's disease center ever go into a nursing home" adds Doody. "The majority of people live out their life at home."

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