Obstacles and Opportunities in Alzheimer’s Disease
Alzheimer’s disease (AD) is a brain disorder that slowly destroys memory and thinking abilities. It generally appears older population (during the mid-60s). In the United States, it is estimated that >5 million people are affected by AD. The commonly reported early symptoms are memory loss, unpredictable behavior, language problems, confusion, etc. Currently, there is no exact cause of AD but previous research studies have shown that there are certain factors which are responsible for developing AD such as depression, hypertension, and history of head injury and the major one is increasing age. The drugs available for treating AD can give temporary relief from worsening of symptoms, but they do not stop AD from progressing. So, there is a need to find better ways to treat this disease, delay its onset, and prevent it from developing.
These three classes (treating, delaying, and preventing AD from developing) have provided a wide opportunity to pharmaceutical industries to grow in terms of research as well as the economy. But they face many challenges for doing so. The biggest challenges for the pharmaceutical industries and their researchers are the high cost of research, lack of recruitment of participants in the clinical trials, and the inability to detect AD early. Due to this, in the past decades, no new drug has been approved for the treatment of AD. Despite this, more than 400 clinical trials and billions of dollars are being spent by the pharmaceutical industries to treat this disease. The high rate of failure of AD drug development is due to the high cost of advancing AD drug development process. Earlier diagnosis can also help to improve the terrible financial burden of AD.
From high screening failure rates to lengthy clinical trials, researchers face recruitment of participants as a second major challenge. Various factors that inhibit recruitment in clinical trials including tough enrolment criteria which may exclude many patients, old age of volunteers, disability, lack of mobility, too many tests, transportation problem, and co-morbidity factors. Due to the less and slow enrolment of participants, AD trials usually take 5-6 years to discover whether a drug is effective or not. However, to overcome this problem, the researchers have now found a new technology, ie, CANTAB to easily recruit participants in the clinical trials. CANTAB recruit is a computerized assessment tool for pre-screening participants into early AD clinical trials. The participants can register and fill the assessment procedure remotely without coming to a clinic.
Among other challenges, researchers have also found a new opportunity for early detection of AD, ie Near-infrared spectroscopy (NIRS). Near-infrared spectroscopy (NIRS) is a non-invasive neuroimaging tool used to measure activation-induced changes in cerebral hemoglobin concentration. Earlier, magnetic resonance imaging (MRI) and positron emission tomography (PET) have been introduced to capture the changes in brain activities. The major problems with these techniques are their expensive and requirement of difficult measurements. The benefits of NIRS make it a possible alternative technique to MRI and PET for a convenient and non-invasive diagnosis or therapeutic monitoring in AD patients in clinical trials.
In this way, cost of research and recruitment of participants in the clinical trials are the major challenges in the drug development process of AD and to overcome this, CANTAB recruit is the new technology for pre-screening participants into early AD clinical trials. Also, the biggest opportunity for pharmaceutical and research industries is to develop measures to detect the early stage of AD. Earlier, MRI and PET were used but, it is expensive to perform these techniques. So, researchers have found Near-infrared spectroscopy (NIRS) to detect early stage of AD, which may also help to reduce the cost of AD trials.