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• Perispinal Etanercept as a treatment for Alzheimer's Disease?

The Penn Memory Center has been receiving many calls inquiring about a recently published case report in the Journal of Neuroinflammation that describes the response of one patient with Alzheimer’s disease to etanercept, a powerful anti-inflammatory medicine.

The authors described their experience injecting the drug around the spinal cord in the neck and then turning the patient upside down briefly to promote diffusion of the drug towards the brain. The medicine, etanercept (marketed as Enbrel), is currently Food and Drug Administration approved for use in rheumatoid arthritis, psoriasis, and other autoimmune disorders.

The authors of the case report describe immediate and sustained symptomatic improvement with weekly treatments. The patient was more alert, more attentive, calmer, his language improved, and his thinking was clearer. Memory impairment, the cardinal feature of Alzheimer’s disease, did not notably improve using a standard test of remembering a brief list of words.

Scientifically, this anecdote is of interest to us because it represents an initial test of a novel anti-inflammatory drug and a novel way to administer a drug that otherwise is not able to get into the brain. Clinically however, it is just an anecdote. The authors say they have used this treatment in other patients with success, but they do not provide compelling evidence, let alone a placebo-controlled clinical trial that is the gold-standard method to demonstrate the benefit of a new medicine. Furthermore, the potential complications and side effects of such invasive treatments are not well described.

The researchers and clinicians at the Penn Memory Center are aggressive in evaluating and prescribing beneficial treatments for cognitive impairments, and we are rigorous in our methods. At this point, perispinal etanercept does not have enough evidence to recommend it as a treatment for Alzheimer’s disease. January 2008.

Click here to link to Alzforum: News web page.

• “American voters getting older”

On January 31, 2008, Jason Karlawish, MD, testified to the Senate Committee on Aging at a hearing titled "Older Voters: Opportunities and Challenges for the 2008 Election" chaired by Chairman Herb Kohl (D-WI).

Click below to:

• link to the Senate Committee on Aging web site to view the web cast.
  
• to read the Associated Press report “American Voters Getting Older”.
  
• to read Dr. Jason Karlawish's testimony.

• Annual Marian S. Ware Neurodegenerative Diseases Research Retreat. November 9, 2007.

Oh better drugs where art thou?

In the wake of the first failed Phase 3 trial of a supposedly amyloid-lowering drug, leaders of Alzheimer disease programs at several major pharmaceutical companies came together to discuss drug development at the invitation of Virginia Lee and John Trojanowski.

Click here for to read Pat McCaffrey’s roundup from the Alzheimer Research Forum web site.

• PENN Neurodegenerative Disease Research - In the Spirit of Benjamin Franklin

“Penn Neurodegenerative Disease Research - In the Spirit of Benjamin Franklin” by John Q. Trojanowski (Neurosignals 2008) showcases the strengths of a large and diverse "slice" of neurodegenerative disease research at PENN.

Click here for more information from Penn Medicine News.

Click here to read the abstract on Pubmed.gov.

• A Vaccine for Alzheimer's

A promising Phase II study is now underway at Penn that is helping pave the way for an Alzheimer’s vaccine by eliminating small proteins from coming together to form plaque. Scientists are also researching a protein in the spinal fluid that might be a predictor for the disease.

Please note, we are not presently recruiting for this study.

ABC 6 Action News' HealthCheck with Anita Brikman aired interviews from the Ralston Center with Dr. Clark and patient Mrs. Josephine Feige about the Lilly-Immuno vaccine trial.

Click here to watch the ABC news video

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According to CBS 3 medical reporter Stephanie Stahl — “It could be one of the biggest scientific breakthroughs ever, a way to treat, maybe even prevent Alzheimer's disease and it's being tested in Philadelphia.” She interviewed Dr. Clark and study participant Ada English on February 5, 2007.

Click here to read the CBS 3 story.

Click here to link to the CBS3 news video.

• Home Visits Improve Willingness to Participate in Alzheimer's Clinical Trials

Jason Karlawish, PhD, associate professor of medicine and associate director of the PENN Memory Center, and his colleagues at the University of Pennsylvania recently completed a study addressing the challenges of recruiting and retaining study participants for Alzheimer's clinical trials. They tested whether redesigned clinical trials might improve caregivers' willingness to participate in Alzheimer's trials by analyzing the value of four possible alterations in the study. June 2007

Click here to read more.

• When Informed Consent is Impossible.. an opinion by Jason Karlawish, M.D. on ABCnews.com

Is research that enrolls patients with Alzheimer's Disease ethical?...an opinion by Jason Karlawish, M.D. on ABC News Health online, January 29, 2007

By definition, Alzheimer's patients have trouble with memory, concentration and attention. They may not be competent to give an informed consent. Without the patient's informed consent, how do we ethically enroll patients with Alzheimer's disease in research?

Click here to connect to ABCnews.com to read the article.

• Philadelphia Inquirer: Probing a Mind for a Cure, February 26, 2006

Bob Moore, diagnosed with Alzheimer's Disease, donated his brain for autopsy to help doctors learn more about causes and prevention of the disease. Read the article online. ($2.95 fee to view archived articles.)