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Researchers have known for decades that inflammation accompanies brain damage from Alzheimer's disease. Several early studies have suggested that "super-aspirins" or nonsteroidal anti-inflammatory drugs (NSAIDs) may help prevent the disease. However, after clinical trials showed that NSAIDs did not help patients who already had symptoms of AD, doctors wondered if these drugs could still help people at risk of developing the disease, but not presenting more symptoms.
To test this hypothesis, researchers at the Faculty of Medicine at McGill University have come up with a new approach to AD prevention trials and have used it to determine whether naproxen, an anti-inflammatory nonsteroidal (RNA) drug, could actually stop the disease before AD symptoms became apparent. Unfortunately, the results are not encouraging, according to a study published in the April 5, 2019 online edition of Neurology®, the medical journal of the American Academy of Neurology.
"To give the history of NSAIDs a further chance of ending well, we enrolled trial participants at the earliest stages of disease development, before they have a disability." cognitive, "says Dr. John Breitner, professor of psychiatry at McGill and lead author of the study. "The resulting test, known as INTREPAD, examined the effects of naproxen in people with a strong family history of AD, but a" perfectly cleansed "memory and other cognitive abilities . "
Develop a new method to evaluate the effectiveness
Many researchers have noted the particular challenge posed by measuring the development of the disease at a time when they could not rely on the symptoms to evaluate the effects of a treatment. To meet this challenge, the McGill University team has collaborated to develop a new Alzheimer Progression Score that has been shown elsewhere to predict the onset of clinical illness over the next ten years or more. The APS measures the early development of the disease by combining many small changes in a composite score.
By applying the PSA to a test sample of 200 people (100 badigned to naproxen and 100 to placebo), the results of INTREPAD showed real changes over the two-year trial period. However, there is no indication that the change in SPA has been reduced in those taking naproxen. "The usual side effects were there," notes Pierre-François Meyer, a PhD student at Dr. Breitner's lab and first author of the study, "but there was nothing to suggest benefits."
"We believe that it is the end of the road for the use of NSAIDs for the treatment or prevention of Alzheimer's disease, and this suggests a need for caution regarding the use of NSAIDs for the treatment or prevention of Alzheimer's disease, and this suggests a need for caution regarding use other anti-inflammatory drugs for this purpose, "adds Dr. Breitner, founder of Director of the Center for Studies on Alzheimer's Disease Prevention at the Center's research center. Douglas Mental Health University Institute. "The world desperately needs a way to prevent this horrible disease," he said, "and many other avenues are under study." In this process, researchers are increasingly emphasizing the importance of publishing negative or "null" test results like this one.
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"INTREPAD: A randomized trial of naproxen to slow the progression of presymptomatic
Alzheimer's Disease "by Pierre-François Meyer, John Breitner, et al., Was published online in the journal Neurology® April 5, 2019 doi: 10.1212 / WNL.000000000000723232
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