Among the many medical miracles of the twentieth century, two stand out: the development of penicillin, the first antibiotic, in 1928, which has saved countless lives; and, at the other end of the century, the gradual change, at least in industrialized countries, the breakthrough in the early nineties, leading to H.I.V., the forerunner to AIDS, becoming a manageable condition.
Magic Johnson, the ebullient former basketball superstar who remains fairly healthy a quarter-century after his diagnosis, has become an icon of sort, to the extent that some people assume he is fully cured. That is not the case. He still takes a cocktail of pills each day. But his name itself has become a metaphor for the prowess of the pharmaceutical industry. In one of my first blogposts, in August 2015, I commented that there was no cure for Alzheimer’s. But then I stated, “That could change, of course, just as things changed in the early nineties, saving the lives of countless others.”
A recent article in the journal Scientific American, reissued in a condensed form, may help raise the hopes of people with Alzheimer’s and their loved ones. The recent article’s title—A New Approach to Alzheimer’s—is followed by an intriguing subhead: The disease’s complexity and multiple contributing factors suggest that combinations of drugs could be more effective than single medications.
The article, written by James Hendrix, states up front that “Having witnessed the success of combination therapy in HIV, cancer and heart disease, the time has come for Alzheimer’s disease.” As a result of a 2016 meeting with the Alzheimer’s Association and other parties, a consensus emerged that the most effective Alzheimer’s treatments may be those who attack on multiple fronts. With researchers developing a deeper understanding of the disease, the picture emerging is one in which new classes of antiviral medications—“each attacking the virus in a unique way”—doctors will be able to prescribe multiple drugs that have demonstrated efficacy.
The Alzheimer’s Association, in collaboration with the Alzheimer’s Drug Discovery Foundation, last year created the Alzheimer’s Combination Therapy Opportunities [ACTO], a vehicle designed to deliver $2 million this year that simultaneously target multiple processes. “An ACTO-funded study must involve repurposed drugs”—those that have been determined safe for using in treating in other conditions.
According to the Scientific American article, a combination of experimental anti-amyloid drugs could more effectively reduce amyloid plaque, one of the two typical manifestations of the disease. In another study, the hormone leptin, which curbs hunger, has shown potential to reduce plaque as well as cellular inflammation. The group’s recommendation is to do more research on animal subjects before it is clear that human subjects would not be at risk.
As the Scientific American article concluded, “We are at a junction of unprecedented promise in Alzheimer’s research. A few decades ago we knew virtually nothing about how Alzheimer’s developed or progressed.” Will this collaboration bear fruit? If so, it will be a very big deal—as big as what happened after AIDS activists declared in 1991 that Magic Johnson was going to die.And, yes, Magic Johnson is going to die, as all mortals do.