ICAD: Biomarkers Take Center Stage in Alzheimer's Field

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By John Gever, Senior Editor, MedPage Today

PARIS – Although disease-modifying treatments for Alzheimer's disease are still years away, research on biomarkers and imaging techniques for identifying individuals most likely to benefit from them is making great strides.

That's the view of William Thies, PhD, chief medical and scientific officer of the Alzheimer's Association, sponsor of the International Conference on Alzheimer's Disease (ICAD) that starts here today.

In an exclusive interview with MedPage Today senior editor John Gever, Thies said that new results on diagnostic and prognostic markers would be among the major highlights of this year's meeting.

A major trend in the field, he said, has been "increasing interest in biomarkers and increased understanding of biomarkers – they're not created equal, there may be different biomarkers that are going to be useful in different parts of the disease."

"It's certainly true that the progress in biomarkers and the progress in new treatments almost has to go hand in hand," Thies added.

Indeed, another trend receiving significant attention at this year's ICAD is early treatment of Alzheimer's disease, before dementia becomes severe.

The recently updated diagnostic criteria for the disease are facilitating early intervention, he said, because they better describe what he called "the continuum of Alzheimer's disease."

These trends are interrelated and will become more so when disease-modifying therapies finally become available, Thies predicted.

"As new medications are developed and [approved], they'll probably receive labeling with some careful instructions about biomarkers used during the diagnostic procedure," he suggested.

Whether those medications will be directed against beta-amyloid protein is still unclear, he conceded.

But Thies said the recent negative results with anti-amyloid drugs did not yet mean the approach was a dead end.

"There are several anti-amyloid therapies that are still in phase III testing. These are the monoclonal antibodies that bind to beta-amyloid," he said.

"I think we're going to see very important data coming out of those trials. I think it's too early to declare the amyloid hypothesis dead."

Those data will not be reported here, but the ICAD agenda does feature results from other studies that will shed light on other aspects of the disease, including:

•Modifiable risk factors
•Traumatic brain injury as a cause of Alzheimer's disease
•Safety of anti-amyloid therapies
•Cerebrospinal fluid proteins and imaging results early in the disease

Thies also mentioned that a critical need for future research is recruitment of potential research participants.

The Alzheimer's Association has launched a service called TrialMatch to place volunteers into research studies – including cognitively healthy and mildly impaired individuals as well as those with overt Alzheimer's disease.

"The hope is to increase the number of people in trials," he said, noting that about 10,000 people are now available in the pool.

"We hope that eventually this will drastically speed the recruitment of people in trials," alleviating a major obstacle to progress.

"Currently, to recruit a full cohort for a phase III clinical trial in Alzheimer's disease, it takes somewhere between a year and a year and a half. That's just wasted time," Thies declared.