Battling Brain Disease: The New Frontier In Treating Alzheimer's Patients

Sometimes when John Chiappetta’s mother makes her much-loved lasagna, she remembers every detail of every step. Other times, if Chiappetta isn’t there to prevent her, she boils the water down to the pot’s metal. Such is the unpredictable nature of the Alzheimer’s disease that she’s battling.

For five years, Chiappetta has been his mother’s full-time caregiver, while working full-time as a senior program manager at Hyatt Hotels and fulfilling his duties as a single father to three boys.

Taking care of his mom is an endurance-testing responsibility. It requires ingenuity, determination and fortitude.



“I’ve had to do a lot of adjusting, and you need a whole lot of patience,” said Chiappetta, who lives in Chicago. “You become a driver [for her], medical advocate and translator. You actually need to become her memory.”

More than 5 million Americans are living with Alzheimer’s disease, and the number is expected to triple in another 35 years. By far the most common brain disorder, Alzheimer’s has long eluded researchers’ attempts at finding its cause. Efforts to develop long-term treatment protocols have fared no better. Most pharma organizations are attacking the disease in either of two ways: pursuing possible triggers or seeking treatments to help subdue symptoms.

Integrating Approaches

But Lundbeck, a global pharmaceutical company with North American headquarters in Deerfield, Illinois, is taking a two-pronged approach — testing medications to minimize symptoms and examining the causes. Its efforts to combat Alzheimer’s are part of the company’s larger mission to target malfunctions of the central nervous system and the underlying mechanisms of brain disorders.

In addition to Alzheimer’s, Lundbeck’s research and development investigates and offers treatments for Parkinson’s disease, schizophrenia, depression and epilepsy.

“Ultimately we’d like to eliminate Alzheimer’s, but until then we’re hoping to change the course of the illness and slow it down,” said Peter Anastasiou, president of Lundbeck North America.

Lundbeck currently has five drugs in clinical trials for Alzheimer’s. Three of them are considered disease-modifying, which potentially could alter the progression of the illness. Two others address the symptoms: one lessens the impact of cognitive deficits; the other calms the agitation that typically occurs in people with Alzheimer’s.

Of the five compounds, the three potentially disease-altering medications are in the very early stages of clinical trials and are not yet named. They are still being studied for safety before they can be tested for their effectiveness.

One is a vaccine that would teach the body to rid the brain of beta amolyid, the chunks of protein that clump together and are believed to block cell-to-cell signals, leading to the cognitive deficits associated with Alzheimer’s. Many researchers believe beta amolyid holds the key to curing the disease.

The second is a drug that Lundbeck hopes will stop the production of beta amolyid altogether. The third is aimed at reducing the accumulation of tau tangles, characterized by protein clusters that are believed to interfere with the cell transport system. This interference prevents nutrients and other necessary supplies from traveling through and nourishing cells, eventually causing the cells to die.

“It’s so important to find out what causes this disease,” Chiappetta said.

Buying Time

Until a cure can be found, two Lundbeck medications might improve the quality of life for patients struggling with Alzheimer’s deficiencies. Idalopirdine boosts the activity of neurotransmitters, potentially improving cognitive function. Early studies have shown some positive effects. Phase III clinical trials are underway.

The other compound, Rexulti (brexpiprazole)‎, is already on the market, but for a different indication. It is FDA-approved to help patients with schizophrenia and depression. Lundbeck is investigating whether the drug effectively reduces agitation in Alzheimer’s patients, a prominent behavior associated with the disease and a leading cause of nursing home care.

Watching someone battle with Alzheimer’s can be heart-wrenching, according to Chiappetta. There are times when he sees his mother fight with herself to find the right words. “Certain days are good and certain days are horrible,” he said. “You just see her language eroding and the frustration. You just have to keep her engaged as much as possible.”

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Battling Brain Disease: The New Frontier In Treating Alzheimer's Patients