Repurposed Drugs Offer a Fast(er) Track to Alzheimer's Treatment Everyday Health MenuNewslettersSearch Alzheimer's Disease News Repurposed Drugs Offer a Fast er Track to Alzheimer s TreatmentNew research highlights how medications used to treat other diseases show promise for dementia. By Don RaufDecember 10, 2019Everyday Health ArchiveFact-CheckedUsing an approved drug for a new use can speed the development of new treatments.Shutterstock (2) Can old drugs be used for new treatments? Recent research is finding that the quickest path to effective therapies to treat Alzheimer’s disease may be via medications that are already on the market to treat symptoms of other diseases. Presentations of recent scientific research at the 12th Annual Clinical Trials on Alzheimer’s Disease (CTAD) meeting this December highlighted the potential of these existing medications. “Alzheimer’s is a complicated, multifactorial disease. There are multiple things that can promote or delay Alzheimer’s, so repurposing drugs makes total sense to me,” says Richard Isaacson, MD, the director of the Alzheimer’s Prevention Clinic at NewYork-Presbyterian and Weill Cornell Medicine in New York City. Howard Fillit, MD, the founding executive director and chief science officer for the Alzheimer’s Drug Discovery Foundation, emphasizes that once these medications are shown to have a positive effect on dementia, they can be available to patients in a shorter timeframe compared with an original compound, which can take 12 to 15 years to move from basic scientific observation to approval by the U.S. Food and Drug Administration (FDA).“You don’t have to start from scratch in terms of research,” says Dr. Fillit. “They have already been approved by the FDA, and their safety profile is known.” New Hope for Psychosis in Alzheimer s The antipsychotic drug Nuplazid (pimavanserin), for example, received FDA approval in 2016 for hallucinations and delusions caused by psychosis related to the neurodegenerative disorder Parkinson’s disease. Phase 3 study results on the medication presented at CTAD demonstrated that Nuplazid is effective in treating psychosis related to dementia as well. In an investigation of 392 patients, Nuplazid was shown to reduce the risk of relapse of psychosis by 2.8-fold compared with placebo. “Reducing the risk of relapse of psychotic symptoms by this magnitude is an important and meaningful outcome, as these are serious events which could lead to poor patient outcomes and a significant increase in caregiver burden and distress,” says Jeffrey Cummings, MD, the director emeritus of the Cleveland Clinic Lou Ruvo Center for Brain Health in Las Vegas. Fillit estimates that between 25 and 50 percent of people with Alzheimer’s will develop psychosis at some point in the course of their illness. Psychosis may take the form of delusions, hallucinations, and physical or verbal abuse. “It’s a very disabling symptom that can ultimately lead to nursing home placement,” he says. “Right now there are no effective approved ways to treat it. This drug could really change the landscape of the treatment of psychosis in patients with Alzheimer’s disease.”Acadia Pharmaceuticals, the drug’s manufacturer, plans to meet with the FDA soon to discuss getting approval to expand Nuplazid’s use for individuals with dementia. Putting the Brakes on Disease Progression br In another presentation at CTAD, Dawn Matthews, the chief executive officer of the biotech firm ADMdx, spotlighted Azilect (rasagiline). The drug acts by slowing the breakdown of the neurotransmitter dopamine in the brain. It’s approved to treat symptoms of Parkinson’s disease, and it’s been shown to improve motor skills and activities of daily living. “We know its mechanism of action, and there was a lot of reason to think that it could be useful for people with Alzheimer’s disease,” says Fillit. Matthews shared data demonstrating that Azilect improved regional brain function, as seen in fluorodeoxyglucose–positron emission tomography (FDG-PET) imaging. The imaging technique can measure the presence of tau tangles in the Alzheimer’s-affected brain, which correlates well with the level of cognitive decline, according to an August 2017 article in Alzforum. With dementia, accumulations of the protein tau collect inside neurons and disrupt the ability of brain cells to communicate.According to Fillit, the results from the trial look promising, and the drug deserves larger analysis. Other Repurposed Drugs With Potential for Alzheimer s br In addition to medications used to treat Parkinson’s disease, therapies for other diseases may also benefit Alzheimer’s patients. Hepatitis D Treatment br In 2018, the FDA granted “breakthrough therapy designation” to lonafarnib for the treatment of hepatitis D infection. A study published in March 2019 in Science Translational Medicine suggests that lonafarnib can stimulate lysosomes (the organelles within cells that contain digestive enzymes) and reduce tau toxins in a mouse model of Alzheimer’s. Diabetes Drugs People with diabetes have a higher risk of developing dementia (up to 73 percent higher) than those without diabetes, according to the Alzheimer’s Foundation. “We’ve known that brains of people with Alzheimer’s have reduced glucose metabolism on PET scans,” says Dr. Isaacson. “What can we do to fight that?” Some initial research, published in May 2018 in the Journal of Pathology, has indicated that Victoza (liraglutide), a prescription drug used to treat type 2 diabetes, may reduce beta-amyloid plaques, decrease inflammation, and slow cognitive decline by improving insulin resistance in the brain. The Alzheimer’s Foundation is now funding a larger study looking into the potential dementia benefit of this diabetes medication. Some investigations have also hinted at the potential of the diabetes drug metformin to reduce Alzheimer’s symptoms as well. RELATED: Metformin Health Benefits Beyond Type 2 Diabetes Blood Pressure Medications Other studies are looking into the possibility that high blood pressure medications may ease problems related to dementia. RA Biologics Biologics for rheumatoid arthritis, such as Enbrel (etanercept) and Humira (adalimumab), are also being analyzed for their anti-inflammatory properties, which may lighten the burden of the Alzheimer’s. “One complicating thing is there is not a one-size-fits-all approach when it comes to Alzheimer’s,” says Isaacson. “There is not going to be a magic bullet to defeat this disease. There need to be multiple bullets targeting different aspects — inflammation, glucose hypometabolism, etc.” NEWSLETTERS Sign up for our Healthy Living Newsletter SubscribeBy subscribing you agree to the Terms of Use and Privacy Policy. 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