Research and possible future brain health treatments

Transcription

1 Research and possible future brain health treatments Cheryl Brandi, DNSc, ARNP, NP-C Roskamp Institute Clinic July 21, 2016 brandi, roskamp institute 1

2 The Roskamp Institute Not for profit biomedical research institute and clinic > 60 staff including Ph.D. scientists, clinicians, Ph.D. students, research associates, technicians, administrative staff and consultants Research targets neurological and neuropsychiatric disorders Funding: National Institutes of Health; Veterans Administration; Department of Defense; Alzheimer s Association; Roskamp Foundation; Pharma; Publicprivate partnerships; Private donations 2

3 Roskamp Institute Programs Roskamp Laboratories Archer Pharmaceuticals - Nilvadipine SRQ Bio Contract Research Roskamp Clinic Neurology clinic Clinical trials Mild Cognitive Impairment, Alzheimer s, Multiple Sclerosis, Migraine, etc. 3

4 Understanding brain health and dementia July 21, 2016 brandi, roskamp institute 4

5 What should I believe? July 21, 2016 brandi, roskamp institute 5

6 The continuum of neurocognitive disease research 3. Treatment of disease and finding a cure 2. Earlier and more accurate diagnosing 1. Prevention, risk factor identification and risk factor modification*** What is the current state of science? July 21, 2016 brandi, roskamp institute 6

7 3. Treatment of disease, finding a cure; Alzheimer s disease Currently only 5 FDA approved drugs 4 drugs came to market between 1996 and 2003 Last drug was approved in 2014, but is a combination of two older drugs No approved drugs work at the disease targets proteins such as amyloid and tau July 21, 2016 brandi, roskamp institute 7

8 Amyloid plaques in brain tissue July 21, 2016 brandi, roskamp institute 8

9 Why has drug development been so slow? Stigma, denial Money Lack of volunteers needed for clinical trials July 21, 2016 brandi, roskamp institute 9

10 Money: Federal funding in billion to cancer 1.2 billion to heart disease 3 billion to HIV/AIDS Only 566 million to Alzheimer s Disease July 21, 2016 brandi, roskamp institute 10

11 Volunteers 70,000 volunteers urgently needed for 150 clinical trials and research studies in the U.S. related to Alzheimer s Disease (National Institute of Aging 2015) July 21, 2016 brandi, roskamp institute 11

12 Clinical trials offer hope for our future Clinical trials are a way to learn if a treatment is effective and safe Most involve drugs and a placebo Very strict laws govern the way clinical trials are conducted July 21, 2016 brandi, roskamp institute 12

13 So Promising advances in Alzheimer s disease treatment Experimental drugs that target specific disease proteins such as beta amyloid, tau, beta secretase Trials ongoing at Roskamp Institute Different uses for older drugs nilvadipine An encouraging Roskamp Institute trial in Europe (NILVAD) July 21, 2016 brandi, roskamp institute 15

14 Nilvadipine, an older drug with a promising new role A blood pressure medication used in Europe Nilvadipine in animal studies was shown to block production of amyloid and increase cortical brain circulation in animal models Phase 3 trials are nearing completion from 9 sites throughout Europe (NILVAD) Data will soon be analyzed, results finalized STAY TUNED!! July 21, 2016 brandi, roskamp institute 16

15 2. Earlier and more accurate diagnosing New imaging techniques an ability to see amyloid buildup on MRI to aid diagnosis IDEAS trial across the US, Roskamp Institute participates Better understanding of Mild Cognitive Impairment Biomarker validation for earlier detection Current study at Roskamp Institute Clinic July 21, 2016 brandi, roskamp institute 17

16 1. Prevention and risk factor modification In the absence of disease modifying treatments, risk reduction takes on new meaning Even with new treatments, risk reduction will be a basic strategy Clinical studies are limited regarding specific interventions, but evidence is sufficient to support modifiable risk factors (Baumgart et el: Summary of the evidence on modifiable risk factors..alzheimer s and Dementia 11(2015) ) July 21, 2016 brandi, roskamp institute 18

17 Risk factors Cannot change age, family history and genetic susceptibility July 21, 2016 brandi, roskamp institute 19

18 Risk factors There is sufficient evidence to support associations or linkages between modifiable risk factors and reduction in risk for mild cognitive impairment and dementia July 21, 2016 brandi, roskamp institute 20

19 Cardiovascular risk factors July 21, 2016 brandi, roskamp institute 21

20 Cardiovascular risk factors for cognitive decline Diabetes strong evidence on increased risk of dementia in people with diabetes Mid-life obesity strong evidence for an increased risk of dementia Mid-life hypertension strong evidence for an increased risk of Mild Cognitive Impairment July 21, 2016 brandi, roskamp institute 22

21 Lifestyle factors that reduce risk Stop smoking Physical activity even mild activity is linked to decreased risk of cognitive impairment Diet combined Mediterranean/Dash diet probably has most evidence among diets for reducing risk of cognitive decline and dementia July 21, 2016 brandi, roskamp institute 23

22 Other risk factors Education fewer years of education linked to increased risk of dementia Traumatic brain injury solid evidence to link to increased risk of dementia History of depression moderate link to increased risk of cognitive decline Sleep {Caregivers of family members with dementia} July 21, 2016 brandi, roskamp institute 24

23 Summary Research regarding neurocognitive diseases is promising but has a long way to go However, YOU CAN reduce your risk now! July 21, 2016 brandi, roskamp institute 25

24 and in conclusion.. July 21, 2016 brandi, roskamp institute 26

25 Roskamp Institute Roskamp Institute 2040 Whitfield Ave. Sarasota, FL Phone: Roskamp Institute Clinic Phone: July 21, 2016 brandi, roskamp institute 27