What do you see as the most significant innovation in Alzheimer’s disease/dementia within the last few years?

Imaging has been the key to unlocking our whole understanding of Alzheimer’s disease. Data from clinical assessments are important, but data from imaging are hard data that tell you what is actually happening in the brain. 

In a clinical study that we are just now initiating, we’ll use imaging to measure glucose uptake in the brain to show the differences in the health of the brain between those of patients on our treatment and those on placebo. 

Why is research so critical in this field?

The answer to that is very simple, in that there have been no new drugs in Alzheimer’s disease since 2003. The point of all this research is ultimately to go from the lab bench to the bedside, and to find a treatment that the patient takes that will help them — a treatment in which we can have confidence that it will provide long-term benefit. That is really the motivating force in research. 

What has research to date taught us about this disease?

Two theories about the disease have divided research over the past decades: amyloid plaques and tau tangles. The field has been dominated by the amyloid theory of the disease, which led to some 25 major late-stage clinical trials that were conducted in mild and moderate Alzheimer's disease patients, and all have failed. Meanwhile, it’s been shown that tau tangles and tau aggregation are highly correlated with dementia, and this pathway remains a very sensible basis for drug development, but it’s only recently that it’s caught on in the field as a viable approach.

What does the future of Alzheimer’s disease look like?

I think that research will focus on early stages of the disease — on the pre-tau and pre-amyloid problems that are going on in the brain of people who are at risk. The real challenge will be to identify these at-risk people and find the markers of risk. 

The future is such that, with an ageing population, particularly in developing countries, there’s going to be a five-fold increase in the number of people that will reach an age when there’s a high probability they’ll get Alzheimer's disease. That’s where the future lies — coming up with treatments that are effective, inexpensive and widely available. At TauRx, we see our business as coming up with drugs that work and can be used safely in a widespread manner.