By Christopher Placek – Daily Herald
More than a decade after hosting clinical trials for two medications now commonly used to slow the progression of Alzheimer’s disease, researchers at Ascension Alexian Brothers hospital in Elk Grove Village are now studying potential new treatments to address the neurological disorder.
“We have these two very interesting studies right now, which are a step further from these two drugs,” said Dr. Concetta Forchetti, principal investigator at the hospital’s neurosciences institute and medical director of the hospital’s memory disorders center.
Patients with mild stages of dementia can take the Food and Drug Administration-approved donanemab, marketed as Kisunla, and lecanemab, marketed as Leqembi. Both attack amyloid plaque buildup in the brain.
In 2010, the hospital was among the first in the country to conduct trials for the drug bapineuzumab, which wasn’t approved but was a precursor to the drugs that were.
Now, researchers are recruiting volunteers for a study on a new drug that targets amyloid proteins. Called remternetug, the medication is derived from donanemab, but is administered in a very different way.
While the two approved meds are given once or twice a month through intravenous infusion, the experimental drug being studied can be administered via injection into fatty tissue under the skin.
“What is peculiar of this medication is that we are testing it ‘sub q’ (subcutaneously),” Forchetti said. “Instead of being given a monthly IV in a medical setting, the patient can do this at home on their own.”
Study participants are between ages 55 and 80, and have very early onset signs of dementia.
In the other study, researchers are focusing on tau, a different protein that builds up in the brain.
They’re now in phase 2B of a three-phase clinical trial involving about 400 people between the ages of 60 to 80 who have early-to-mild signs of dementia. In this phase, the product is tested for possible side effects and benefits. If it’s successful, thousands of people could get treatment to confirm the drug’s efficacy.
“The future is going to be when we can have an antibody or whatever treatment that can stop the tau from killing the brain cells,” Forchetti said. “It probably will be a cocktail of drugs that will include amyloid and tau blockers, and support for neuron regeneration to rebuild or protect those brain cells that are still functioning.”
Forchetti cautions that the new drugs have shown to be most effective when Alzheimer’s is diagnosed early. Even then, the treatments won’t stop the disease, but they can slow it down.
Many people who come to the Elk Grove hospital’s memory care clinic are advanced by the time they see Forchetti for the first time. She estimates a quarter of patients show early signs of dementia, a quarter are very impaired, and the remaining half have mild to moderate symptoms.
“The earlier you capture the symptoms and the disease and the earlier you start treatment, the most effective they will be,” Forchetti said.
There are two ongoing studies for patients in the severe cognitive stage, she added. Compounds are being tested to support brain cells that are still alive to function better.
Forchetti, who has been in the medical field for 34 years, spends three days a week on the research side and the other two days seeing patients in the clinic.
There, Forchetti and her staff that includes a nurse, advanced nurse practitioner and social worker meet eight to 10 new patients per week. Each first-time visit includes a physical exam and 30-question cognitive test.
Forchetti also meets separately with family members in a nearby room. Patients undergo an MRI and blood work, too.
Dr. Brian Leahy, a neuropsychologist, does additional testing of memory and other thinking abilities, and together, they provide a diagnosis within weeks. The doctors often make referrals to Dr. Konstantinos Kostas, a health psychologist who conducts talk therapy with both patients and families.
In 2018, the hospital’s foundation provided funds to hire the social worker, who helps families access resources and find care options such as adult day care, in-home service, assisted living and nursing homes.
“We are all here next to each other,” Forchetti says. “It’s a net. Each is a very important component, and we all interact with each other.”