Held in a historic skyscraper built in 1932 for a Philadelphia bank, the seventh conference on Clinical Trials on Alzheimer’s Disease drew 715 scientists to this city between November 20 and 22. CTAD featured a sprinkling of new trial results and enthusiasm about treating agitation in AD, but most of the activity reflected a field trying to rebuild itself from the ground up. Trialists swapped notes on implementing new diagnostic criteria in therapy trials, enriching trial populations, and exploring home-based assessments and other tools to support prevention trials. Secondary prevention sounded positively mainstream and has become the stuff of large-scale collaborations. Rusty Katz, formerly of the FDA, implored trialists to stop obsessing over disease modification and to aggressively go after big therapeutic effects instead. Those, Katz said, may require a commitment to co-develop combinations of investigational drugs.
A sense of change on all fronts pervaded the Clinical Trials on Alzheimer’s Disease conference. Scientists shared their early experiences of what works and what does not as they begin trials with newly defined cohorts, new diagnostic criteria, and new outcomes.
At CTAD, former FDA neurology leader Rusty Katz urged Alzheimer’s trialists to stop fussing over disease progression. He recommended going after a large effect, regardless of whether it can garner a label of disease modification. That, he says, may mean combination trials.
A CAP symposium opened the CTAD conference, indicating that presymptomatic treatment and “federated” research have become mainstream thinking in Alzheimer’s therapy development. EPAD is pulling together European sites.
Researchers at CTAD reported seeing biomarkers budge in active and passive immunotherapy trials, but measurement techniques and screening protocols still need improvement for early stage trials to succeed.
Researchers at CTAD announced the end for two active immunotherapies, along with the curious story of a placebo as a treatment and the start of a new antibody.
Researchers at CTAD advanced tau research on several fronts, correlating tau PET with Braak stage and memory loss, and introducing a new tau model and therapeutic antibody.
Internet and tablet-based cognitive tests were trendy at CTAD. If they prove their worth, they may provide a quicker and cheaper way to screen large numbers of people for trials, and track cognitive decline more accurately.
New therapeutics such as plant-based estrogens and neurosteroids caught notice at CTAD as an approach to try to prevent cognitive decline in women who metabolic markers indicate may be at risk for Alzheimer's.
Speakers at CTAD presented new treatment approaches, including a combination of two repurposed drugs that have no activity by themselves.
At CTAD 2014, potential drugs for agitation, aggression, and other psychiatric symptoms of Alzheimer’s disease emerged as a prominent theme.
Researchers at CTAD added to growing evidence that brain amyloid accumulation presages cognitive decline, although several different factors influence how fast that decline will happen in a given person.