In a new study from Alzheimer’s Drug Discovery Foundation, researchers found a common drug for ALS can slow brain metabolic decline and have a positive effect on cognitive performance versus placebo in people with mild Alzheimer’s disease.
Riluzole is a drug that has been used for more than 20 years to slow the progression of ALS, commonly known as Lou Gehrig’s disease.
Researchers say it is a repurposed drug, which helps speed the research process.
It targets an important and understudied biological mechanism that goes awry with aging, and the rigorous design of this trial measured both biomarker and clinical outcomes.
In the study, the team assigned 50 patients aged 50 to 90 years to receive either the active drug or placebo twice daily for six months.
Riluzole works by modulating a neurotransmitter in the brain called glutamate, which plays an essential role in the ability of nerve cells to send signals to one another.
Glutamate dysfunction is thought to begin a cycle of toxicity that underlies the development of Alzheimer’s disease.
The study met its main primary outcome, confirming a difference in brain metabolic changes between patients on active treatment and placebo.
The changes were measured and analyzed using brain scans. The team found changes in scans correlated with cognitive decline and predicted Alzheimer’s disease progression.
They also found big changes in glutamate levels and correlations between cognitive measures.
Finally, several regions of the brain showed preserved glucose metabolism, but most prominently a region called the posterior cingulate which is a hub network for Alzheimer’s disease.
The team says the promising results support moving the drug into a phase 3 trial with larger numbers of patients followed for a longer time for further testing of safety and efficacy.
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The study is published in Brain. One author of the study is Howard Fillit, M.D.
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