Greatest Challenges in Repurposing Alzheimer Drugs: Feixiong Cheng, PhD

"We need to focus on clinical data homogenization. There are many different health care systems and hospitals that use different criteria and end points to validate the diagnosis of AD. This makes our clinical trial design very challenging.”

The use of repurposed drugs within the Alzheimer disease (AD) clinical pipeline has become an increasingly attractive route for development in recent years. There are several reasons why a particular drug might be chosen, most of which are related to its specific mechanism of action and potential to be effective in targeting a single aspect of the brain, such as an anti-inflammatory agent, for example.

One such drug, sildenafil (Revatio), demonstrated its promise as a candidate for prevention and treatment of patients with AD in a long-term study presented at the 2021 Alzheimer’s Association International Conference (AAIC), July 26-30. Lead author Feixiong Cheng, PhD, and colleagues found that use of the drug was significantly associated with a 69% reduced risk of AD compared with matched non-sildenafil users (HR, 0.31 [95% CI, 0.25-0.39]; P <1 x 10-8). Despite the positive results of this study, Cheng claims there are still aspects of the disease which make it challenging to utilize repurposed drugs.

Cheng, who is an assistant professor at Cleveland Clinic, notes that there remain inconsistencies with the way clinical trials are designed and which outcomes are used, making it much hard to gauge the clinical benefit of these treatments. He sat down with NeurologyLive to discuss these issues, and what needs to be addressed to ease the process of researching repurposed drugs in AD.

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REFERENCE

Cheng F, Fang J, Zhang P, et al. Sildenafil reduces the incidence of Alzheimer’s disease. Presented at 2021 AAIC Annual Meeting; July 26-29. Abstract 254