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Biotech Science

Alzheimer's Treatment Mooted 79

Posted by timothy
from the important-progress dept.
aminorex writes "Enbrel (etanercept) has been immediately, markedly, and consistently effective in all Alzheimer's patients, according to a report in Science Daily. The original research article is available online at the Journal of Neuroinflammation web site. "We can see cognitive and behavioral improvement in a patient with established dementia within minutes of therapeutic intervention" comments one Journal editor." "All Alzheimer's patients" may be over-optimistic, but according to the article, though the research it concerns has been heavily focused on a single patient, "many other patients with mild to severe Alzheimer's received the treatment and all have shown sustained and marked improvement."
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Alzheimer's Treatment Mooted

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  • Bad Title (Score:2, Insightful)

    by Anonymous Coward
    Mooted... I do not think you know what that word means.
    • Re: (Score:1, Funny)

      by Anonymous Coward
      Inconceivable!
    • actually, they do (Score:5, Informative)

      by BitterAndDrunk (799378) on Wednesday January 09, 2008 @06:42PM (#21976866) Homepage Journal
      But it's an annoying fucking word, because its two meanings are actually opposite of one another:

      1. To bring up as a subject for discussion or debate.

      2. Of no practical importance; irrelevant.

      Very obnoxious word that way.

      • by Jhon (241832) on Wednesday January 09, 2008 @07:38PM (#21977622) Homepage Journal

        1. To bring up as a subject for discussion or debate.
        2. Of no practical importance; irrelevant.

        Seeing how effecient and successful the UN runs, I think perhaps you could read that as "To bring up as a subject for discussion or debate is of no practical importance and irrelevant".

        Glad we cleared that up.
      • Re:actually, they do (Score:4, Informative)

        by stonecypher (118140) <stonecypher@gmail.STRAWcom minus berry> on Wednesday January 09, 2008 @09:05PM (#21978588) Homepage Journal
        You're not entirely correct. You've taken one correct meaning and split it into two incorrect halves, then ratified the second half by confusing conjugations.

        The verb "[to] moot [something]" is to raise an issue for the specific purpose of displaying it to be unimportant; this is the sense in which the article uses the word. Mooting something is an active and target-specific process whose intent is to weed out irrelevancies. If you have done either 1 or 2, but not the other, you have not mooted something. There is only one meaning, and it is not internally inconsistant at all.

        Meaning number two is also the way the past tense adjective is spelled/pronounced. However, it is common in English to have an action and its result adjective be the same, despite that the result adjective represents only the end state of the action: I shot him, he was shot; what you've suggested is to point out that shot has two meanings, one to engage in the act of shooting someone, and also two, to be in the state representing having been hit by a bullet. The verb and its past tense correlated adjective are simply frequently structured thusly.

        It's interesting, though, that this divide should seem apparent.
        • by Daengbo (523424)
          The verb and its past tense correlated adjective are simply frequently structured thusly.

          I'm confused about what you mean here.
          1. I shot him. This is past tense in the active voice. (shoot/shot/shot)
          2. He was shot. This is past tense (was) in the passive voice, using the past participle (shoot/shot/shot)

          What is a past tense correlated adjective? The past participle is nomally the one used as an adjective (e.g. The man was beaten -> The beaten man).

          • He means when you say something like "Freddy was shotingly shot last night." Which is funny, cause I just happened to say that to my wife the other day.
      • by Trogre (513942)
        Since (2) is the only meaning that people seem familiar with, can we geeks perhaps agree to never, ever use that word in the (1) context again, or just abandon it altogether?

        Thanks,

    • by famebait (450028)
      Probably just one of those vertical-flip typos.
      What he meant was "w00ted!".
  • by Ichoran (106539) on Wednesday January 09, 2008 @06:26PM (#21976644)
    I'm really not sure why this "study" was worth publishing. Where are the statistics of patient status after injection of drug vs. injection of drug-free control? How about a timecourse? Or anything besides anecdotes from one patient?

    The hype on the article compared to what is shown is shocking. Even if the compound is a silver bullet that instantly and completely reverses Alzheimer's, you'd never know it from a paper like this. So this is an essentially useless bit of PR.
    • by Otter (3800) on Wednesday January 09, 2008 @06:51PM (#21977022) Journal
      Also, this is a widely prescribed drug! It seems unlikely that it has massive, instantaneous effects on cognitive function that no one has noticed before.

      As with the miraculous improvement in solar power efficiency in the next story, I'd love for this to work out but am not holding my breath.

      • by Anonymous Coward on Wednesday January 09, 2008 @07:05PM (#21977222)
        Also, this is a widely prescribed drug! It seems unlikely that it has massive, instantaneous effects on cognitive function that no one has noticed before.

        I know it's wrong to read the article, but to work on Alzheimer's, the drug was injected into the spine. This is definitely an off-label use. Most likely, it doesn't cross the blood brain barrier. If this works, it might be possible to make a similar drug which can cross it.
        • Re: (Score:2, Interesting)

          by virtualXTC (609488)
          It isn't likely that AmGen would attempt to revise the structure of etanercept as they would then have painstakingly go back though every phase of clinical trials again with even the slightest modification. If they use the same product, they only need to complete Phase IIb (efficacy) and Phase III studies to market the drug for this now off-off label use.
          While an injection to the spine may not seem ideal for patients, it would prove beneficial as there almost certainly would be many competitors to foll
          • Re: (Score:2, Interesting)

            by muridae (966931)
            It's also not likely that AmGen or Wyeth will work from Enbrel simple because it's a huge protein structure. 51234.9 g/mol is not tiny by any measure. Tweaking a protein to get through the blood brain barrier might not be the best way to go. This may be just a small part of the protein at work, or spinal injections might just be the simpler way to deliver it.

            They could always re-patent some new delivery method, maybe a better diluent.

        • by Da_Biz (267075)
          Uh, it's been a few years since I took Human A&P, but last time I checked, if you were injecting something into the spine (i.e., in a manner similar to doing an lumbar puncture), you WERE crossing the blood-brain barrier.

          As for this drug, hell, who knows.
          • by barakn (641218)
            The AC who wrote the parent to your post obviously knew that. He/she was saying that it doesn't cross the BBB when used on-label, not off-label.
      • Creatine is another inexpensive drug that has amazing positive effects on PTSD and Alcoholism, for example.

        Drug usage by large numbers of patients means we have a lot of literature on side effects and dosage levels of course.

        So it's not bad that many people use it.

        But I too agree that I don't buy the hype that it's the best thing since sliced bagels ...
    • by Wilson_6500 (896824) on Wednesday January 09, 2008 @07:53PM (#21977804)
      My two-minute Pubmed screening (dinner's getting cold) shows that it seems that this guy's more recent papers, at least, are all technical note-like submissions in online journals. He also has some noted conflicts of interest. However, there is one pilot study. I don't know if this [nih.gov] link will work without going through Pubmed, but this is a year-old pilot study that is probably not the one referenced in the article. They basically conclude, like so many other pilots, that the treatment is promising but needs more rigorous study.
    • How would censoring a potential Alzheimer's cure (and one that makes sense based on fairly well-established theory) on the basis of the methodology used to conduct the research improve the scenario?

      If the research doesn't hold up, the community will figure it out. Now that the cat is essentially out of the bag, people are going to perform their own experiments to confirm or refute these claims. Even if this particular treatment doesn't work, the paper still contains the germs of ideas required to produce

      • Re: (Score:2, Insightful)

        by Ichoran (106539)
        The issue is not about censoring a plausible idea. The question is whether highly hyped papers with extraordinarily little data are a good idea.

        The problem with publications that have n=1 and consist of anecdotal observations is that they are highly unreliable. Since most "negative result" papers never get published, allowing unreliable anecdotes to be published leaves a trail of debris in the literature--you see various promising-sounding papers with no follow-up. You can surmise that the claims were pr
    • Amgen and their "studies"... Until we see some hard data on things such as life expectency, real cognitive improvement and, above all, safety, this is just a press release with big words.
    • Somebody hasn't looked up the references! There was a prior 6 month study with IIRC 15 participants. Linky: http://www.medscape.com/viewarticle/529176 [medscape.com]
      • by Ichoran (106539)
        The prior study was interesting, and was published. The new one doesn't add much.
  • by ArsonSmith (13997) on Wednesday January 09, 2008 @06:32PM (#21976718) Journal
    Do we really want to put people on new drugs like this? What if in 40 years all these people come down with some kind of cancer?
    • Re: (Score:1, Funny)

      by Anonymous Coward
      Forget about cancer. I think patients turning into logs is a far more urgent issue.
    • Re: (Score:3, Informative)

      by RetroGeek (206522)
      From the original article:

      potential risks of etanercept, including infection, cytopenias, possible increased risk of lymphoma and demyelinating disease, death, eye inflammation, and congestive heart failure;
    • Re: (Score:3, Insightful)

      by geminidomino (614729) *
      Not sure if you're kidding but aren't most Alzheimer's patients old enough that 40 years down the road isn't a big concern for them?
    • Re: (Score:3, Insightful)

      by vux984 (928602)
      Do we really want to put people on new drugs like this? What if in 40 years all these people come down with some kind of cancer?

      Do the math.

      I think a 75 year old diagnosed with alzheimer's wouldn't blink at taking a chance on that. Coming down with cancer at 115 is not going to impact him much. He'll probably have died 15-25 years prior.

      And I think even a 35 year old diagnosed with alzheimer's would probably take that chance. Choosing cancer in your 70s vs severe dementia by 40... its not a call I'd find ha
      • Re:Log term effects? (Score:4, Informative)

        by Danse (1026) on Wednesday January 09, 2008 @07:42PM (#21977682)

        Do we really want to put people on new drugs like this? What if in 40 years all these people come down with some kind of cancer?

        Do the math.

        I think a 75 year old diagnosed with alzheimer's wouldn't blink at taking a chance on that. Coming down with cancer at 115 is not going to impact him much. He'll probably have died 15-25 years prior.
        Slasdot. Where everyone plays the straight man, without even realizing it.
      • by 7Prime (871679)
        Captain obvious to the rescue!

        "I still don't know what sarcasm is, but whatever it is, it must be stopped!"
    • by tolomea (1026104)
      Then they get 40 years to help us find a cure for cancer, at this stage I think that's a fairly safe bet.
    • What if in 40 years all these people come down with some kind of cancer?

      Well, let's see. Since Alzheimer's is predominantly a disease that effects the elderly, I think you'll find quite a few of them willing to take risks like that.
    • by Blakey Rat (99501)

      Do we really want to put people on new drugs like this? What if in 40 years all these people come down with some kind of cancer?


      Is there a single person with Alzheimer's Disease and a life expectancy > 40 years? Somehow I think that's an acceptable risk.

      It's funny. Laugh.

      Oh yeah, cancer, Alzheimer's... it's a hoot! ;)
      • Re: (Score:2, Informative)

        by WillAffleckUW (858324)
        Is there a single person with Alzheimer's Disease and a life expectancy > 40 years? Somehow I think that's an acceptable risk.

        No.

        The average person with Probable Alzheimer's Disease status (there is no such thing as certain, until we take your brain and slice it and stain it, actually) has a life expectancy, even if they got early onset AD at around age 40, of at most 20 years.
    • Etanercept is not a "new" drug, in the sense that it has already been trialed and approved for use in various inflamatory conditions such as Rheumatoid Arthritis. What concerns me is use of the perispinal injection and what trials have been conducted for this method of delivery. It looks like there is a link between this study and other research by Dr Edward Tobinick. I found a reference to a 6 month trial of this treatment involving 15 patients: http://www.medscape.com/viewarticle/529176 [medscape.com] (registration req
    • by Valdrax (32670) on Thursday January 10, 2008 @12:03AM (#21980116)
      I know you're joking, but I'll take cancer over Alzheimer's. Even if the drug directly caused it. I may die in miserable pain, but I'll die as me.
  • by LithiumX (717017) on Wednesday January 09, 2008 @06:37PM (#21976796)
    For all the medical problems society obsesses over treatments for (cancer, aids, and other popular areas), Alzheimer's (and senility in general) is the one that scares me the most. I would rather die in pain, with my mind intact, than slowly forget who I am.

    My paternal grandmother died before Alzheimer's was well recognized, but in retrospect it's pretty likely to be the cause of her condition. My grandfather, having seen his wife forget who he was, was always far more afraid of going down that same path than he was of his own approaching end - and I can easily see his point.

    The worst part about growing old isn't physical frailty... it's the slow breakdown of cognitive power. Of course, as a 33-year-old I can say this with absolute authority. The worst part of *that* is that it doesn't wait to start until you're old, either. I'm sure most of you have noticed changes over the years, and not all of them good.

    Here's a question that's been on my mind lately. How would most of you rate changes to how your mind has worked over the years? Have you noticed your reflexes aren't what they were when you were a teenager? Looking at any older writings of yours, have you ever had the feeling that your imagination may have grown more refined, but also lost some of it's raw power at some point? Regardless of the cognitive rewards of time and experience, are there any earlier capabilities that you feel you may have lost some grip on, or even noticed more clearly in younger coworkers or relatives than you used to?

    In my case, for example, I've noticed that in a video game, I just don't react to unexpected situations quite as fast or well as I used to. I remember charging into a room in Doom, blasting everything I saw and dodging almost every shot - whereas lately I tend to get hit more often - I don't do the duck-and-dodge like I did in my teens and early 20's. On the other hand, I'm much more calculating in every move I make, and find it easier to manipulate computer opponents than it used to be - even with all the advances in AI. I don't have the raw speed and reaction time that I used to, but the intellectual component comes more readily and with virtually no effort compared to before.

    What do you younger guys think of the minds of older coworkers? What about any of you in your 30's and 40's, in dealing with people younger or older than you on an intellectual level? And of the most interest to me, how do you geezers (I know there's some who come here - maybe even a handful) relate to us 30-somethings? Do we seem like slightly inexperienced versions of your peers? Or do we seem like idiot children with fast reflexes but weak comprehension?
    • Re: (Score:3, Interesting)

      From personal experience I tend to 'learn' a response to certain situations (patterns of AI in games for eg). The first few instances are all reaction, but as time goes on it starts to become stimulus-response. I suspect that as you get older you accumulate a larger set experiences from which you can draw - simultaneously giving you a greater depth and refinement to your response, but requiring less and less pure reaction.

      What you don't use, you lose. I dare say that just as physical fitness, which used t
      • Most of my cow-orkers are idiots, regardless of age, so I guess that the only conclusion I can draw from this is that as I've gotten older (I just turned 38 a couple of weeks ago) I've grown more cynical and less tolerant of others' mental shortcomings. ;-)

        As for reflexes, they've slowed a bit but not as much as I'd feared they would back when I was a teenager. I can still pull off the occasional double-jump-then-headshot-in-midair-while-maneuvering-around-the-incoming-rocket maneuver, but it's less common
    • Re: (Score:1, Interesting)

      by Anonymous Coward
      Here's a question that's been on my mind lately. How would most of you rate changes to how your mind has worked over the years? Have you noticed your reflexes aren't what they were when you were a teenager? Looking at any older writings of yours, have you ever had the feeling that your imagination may have grown more refined, but also lost some of it's raw power at some point? Regardless of the cognitive rewards of time and experience, are there any earlier capabilities that you feel you may have lost some
      • by QuickFox (311231)
        Regarding your theory, I think it may be spot-on, I seem to remember reading that studies have shown precisely this, that men with more frequent ejaculations run less risk of prostate cancer.

        Regarding the very sudden disappearance of your sex drive, I think you should explore the cause, because it may be an early warning about far more serious problems building up without you noticing.

        I think the suddenness indicates that it very likely it's due to (possibly unnoticed) severe stress. In that case the stress
      • Re: (Score:3, Interesting)

        by Magada (741361)
        Still unsure if you're a troll, but... the statistical corellation between the frequency of ejaculations and prostate cancer likelyhood is well-documented. Sex is good for you, even if you do it one-handed!
    • Re: (Score:3, Informative)

      by CharlesEGrant (465919)

      The worst part about growing old isn't physical frailty... it's the slow breakdown of cognitive power. Of course, as a 33-year-old I can say this with absolute authority.

      I'm sure circumstances vary widely, but my experience is just the opposite. In the last few years my wife and I have lost all four of our parents: hers to heart disease and Parkinson's, mine to heart disease and Alzheimer's. None of them is a picnic, but from what I saw, Parkinson's was a much harder road then the others. The initial dia

    • by syousef (465911)
      Whether it's brain or body, the rule of fitness in nature is use it or lose it. If you're not exercising your brain and your body every day you can expect them to deteriorate. Some forms of deterioration are more permanent than others. The aging process certainly comes into it as well, but it's not the end all be all. For example could it be that you react less quickly in video games because you play them less often than when you were younger? At least might that not be a contributing factor?
    • Actually, being in the 30's too, I'd say it's exactly the opposite image than you paint.

      One thing I've eventually recognized, and struck me as very interesting, is that your own impression of how much you know doesn't depend on age, as such. If you were to plot Y = how much you think you know, vs X = how much you actually know, it would look pretty much like a Gauss curve, with a very early peek.

      When you're first learning a new domain, be it programming or playing the guitar or playing Go, at first your own
  • Well, that is different from my understanding of the disease. I saw a program on PBS called "Brain Fitness" and they talk about a lot of things related to the brain. They touch in Alzheimer's and what the internal physical effects are.

    It's hard to believe that a degenerative disease can be corrected almost instantly. They talked about the connection between different cells and the multiple connections to those cells with other cells that give people the ability to put ideas together. They said that whe
  • by Dunx (23729) on Wednesday January 09, 2008 @06:41PM (#21976862) Homepage
    With any luck this treatment will be (a) effective enough, and (b) available enough in the UK for it to have a positive effect on Terry Pratchett's condition.
  • This news is very bright. I've seen the effects of Alzheimer's, and it can be horrifically damaging not only to the immediate sufferer, but to their entire family. This sort of dramatically, immediately effective solution for a very real and pressing human need is why science and technology are outrageously cool.

    Amgen and Wyeth jointly market Enbrel. Given the size of the aging boomer population, I expect this to make a huge amount of money. Therefore, I'm planning to put my liquid investment funds into
    • Don't be so sure about the generics at this point. Etanercept is a biological (conjugated soluble TNF-alpha receptors, if I'm not mistaken) and the high costs of getting into biotech, as well as the lack of any clear regulatory pathway for 'biosimilars' has acted as a barrier to generic entry in the past. On the other hand, if this relatively simple drug is shown to be active against Alzheimer's, I'm sure it would create a market incentive sufficient to drawn SOMEBODY new into the market.
    • Congratulations - you have just been manipulated by the submitter, who was hoping this would happen.
  • The scientific discussion is still ongoing, IMHO.

    The problem mostly is that we're still dealing with symptoms and not with the underlying mechanistic fault that causes AD.

    For example, we're investigating various drugs that remove plaque in the brain, but the problem arises that we don't have anything that actually corrects the mechanism which creates the plaque in the first place. And most of the treatments are moderately risky so far.
    • Re: (Score:3, Funny)

      by Hatta (162192)
      You might like some NaOH to go with that HCl.
      • Re: (Score:2, Funny)

        by DirkGently (32794)
        ...for those of you that had chem at 8am on a monday, when you combine those two you get salt @ water. I just had to point that out because I thought it a particularly funny nerd-joke and I didn't want anyone to miss it.
      • I was going to use NaCl, but I thought Hydrochloric Acid would be much more fun.

        By the way, don't use dihydroxide, it's poison!
    • by paxmark1 (636441)
      Be interesting if they try it out on Down's dementia. I've seen the present generation drugs buy a couple years for individuals with the similar Down's dementia towards the end. (I really was quite skeptical about the drugs.) But it just buys some quality time, gives caregivers a little more time to get ready for the end. peace
      • Good points. Most people don't realize that virtually all Down's Syndrome subjects eventually will develop Dementia, and then die (fairly young).

        Anything that helps with symptoms for said patients is probably a good thing, even if it doesn't "cure" the underlying problem.

        One hopes that the drug is useful for Dementia for AD, DS, and other related problems - even if it doesn't cure someone, if it can keep them more functional and less demented, the risk might be far less than the reward.
  • by a_d_white (458540) on Wednesday January 09, 2008 @07:42PM (#21977690)
    While the basic biology seems sound, this result is from only one patient while one of the authors holds stock in the company that manufactures the drug and has applied for several patents for its use in treating Alzheimer's.

    Pardon me while I await the large sample, randomized controlled double-blind study by authors with no competing interests to confirm these findings.
  • I'm not a doctor, but as a Slashdot Editor, I feel free to correct those who are.
  • Now, who are you again?
  • It's an old article, but if you really want to know about Alzheimer's research, look into what they've been able to do using the Pittsburgh Compound [sciencedaily.com].

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