ALZFORUM - Advisory Panel Grapples with Combination Therapy


Of the 199 windows on the wavy walls of the Lou Ruvo Center for Brain Health in Las Vegas, no two are on the same plane. A specialized plaster coating on the walls ensures that the acoustics ring true amid this architectural free-for-all. The setting uncannily echoed the vibe at Opportunities and Challenges in Combination Therapy for Alzheimer’s Disease, an advisory panel meeting that took place at the Frank Gehry-designed building on May 28. Twenty-one clinicians, computational modelers, regulators, and leaders from foundations and pharma gathered to chart a path for using repurposed drugs in combination trials for Alzheimer’s. In 13 presentations and a two-hour discussion, they debated how drugs should be selected and whether combo trials were even ready for prime time. In the end, the panel concluded that combination therapy, in one form or another, may be needed to truly make a mark on AD. Leaders from the Alzheimer’s Association and the Alzheimer’s Drug Discovery Foundation (ADDF) agreed to request proposals for combination therapies on repurposed drugs, with details to come.

A push for combination trials has emerged at conferences and formed the basis of several small meetings in recent years (e.g., Feb 2013 conference news). The advisory panel in Vegas had the specific goal of discussing combination trials using repurposed drugs, in particular drugs aimed at targets other than amyloid. The meeting was co-hosted byHoward Fillit of the ADDF in New York and Jeffrey Cummings of the Cleveland Clinic in Las Vegas, who respectively fund and run AD trials on drugs already approved for other conditions. Because these drugs have passed safety hurdles, they could be used right away if they also work for AD, Fillit told the group. The focus on non-amyloid therapies is purely a function of efficiency, he said. Because pharmaceutical companies already pour millions into amyloid-based therapies, it makes sense for research foundations, clinics, and academic and philanthropic institutions to focus their efforts elsewhere, he said. However, others at the meeting considered it unnecessary to exclude amyloid.

Read more at ALZFORUM.