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The cancer playbook may lead to new Alzheimer's drugs It's been notoriously difficult to develop medicines for Alzheimer's disease, the sixth leading cause of death in the United States. Each year, it seems, pharmaceutical companies release data from studies of promising drug candidates that merit only a collective sigh of disappointment. In search of fresh ideas, researchers have begun to borrow a phrase or two from the more familiar language of cancer treatment. Some scientists are studying precision medicine, or personalized medicine, which is routinely used to treat breast and colon cancers. Other researchers are focusing on immunotherapy, an effective form of medicine for skin, lung, kidney, bladder and other cancers. This translation of the cancerfighting vocabulary to Alzheimer's disease, though, is not always simple. Adapting precision medicine

"In precision medicine, in order to apply the most effective treatment possible, doctors select treatments based on the patient's genetic profile," explained Dr. Christiane Reitz, assistant professor of neurology and epidemiology at the Columbia University Department of Neurology. The first step when applying precision medicine to Alzheimer's disease is to learn "as many of the genetic variants as possible" that cause this common form of dementia, said Reitz, whose research focuses on identifying both genetic and non-genetic factors that contribute to changes in the brain. "There are diseases that are caused by only one gene or very few genes," she said. Huntington's disease, a classic example, is caused by a single gene mutation: If you have the

mutation, you will develop the disease. Late-onset Alzheimer's, though, is nothing like Huntington's or even most diseases. "There are likely more than a hundred genes involved in Alzheimer's," Reitz said. "We know some of them but not all. We need to identify the remaining ones." In a recently published study, Reitz noted that scientists have mapped "27 susceptibility loci" for Alzheimer's disease: regions on the chromosome that are most likely to mutate and thereby contribute to the risk of that disease… .Since there may also be a variety of causes of Alzheimer's, scientists hope that they will be able to identify the specific cause of a patient's disease by sequencing his or her genetic profile, Reitz explained. "Then,

the most effective treatment for that patient can be determined and applied." Such is the case with one experimental drug presented last week at the 2018 Alzheimer's Association International Conference in Chicago.Restoring 'cellular balance' Dr. Harald Hampel, a professor at Sorbonne University in Paris, explained that the experimental drug, Anavex 2-73, a precision medicine candidate from specialty pharmaceutical company Anavex Life Sciences Corp., activates the Sigma-1 receptor… "If you wait until people have got significant cognitive problems, then the damage is already done," Williamson said. "I personally think it's going to get better once we have an effective treatment.".Read More

Most Seniors Uninformed on Opioid Use A new survey suggests health care professionals are giving short shrift to their older patients when it comes to explaining the risks of opioid painkillers. Researchers found that most older Americans who are prescribed opioids aren't advised about the dangers of the drugs, how to use fewer of them, when to use non-opioid alternatives, or what to do with leftover opioids. The poll was conducted by the University of Michigan Institute for Healthcare Policy and Innovation, and sponsored by AARP and Michigan Medicine, the university's academic medical center. "We know that unused opioid medications that linger in homes are one of the primary pathways to diversion, misuse, abuse and dependence. As prescribers, we must find opportunities to

discuss safe opioid use, storage and disposal with our patients," said Dr. Jennifer Waljee, codirector of the Michigan Opioid Prescribing Engagement Network. She is also an associate professor of surgery at Michigan Medicine. "It is critically important to provide a detailed plan for patients who get opioids for pain management and resources for disposal," she said in a university news release. The poll of more than 2,000 adults, aged 50 to 80, found that nearly one-third had received an opioid such as OxyContin or Vicodin in the past two years, mainly for arthritis pain, back pain, surgery and/or an injury. Most of those patients said their doctor, pharmacist or other

health care provider talked with them about how often to take the medication, but far fewer said they received other types of important advice. Less than half said their provider counseled them about the risk of addiction or overdose, and slightly more than a quarter said their pharmacist provided counseling. A slightly higher number said their doctor or pharmacist outlined ways to reduce the amount of opioids they were taking. Only 37 percent of patients said their doctor discussed what to do with leftover opioid pills, while 25 percent said their pharmacist had done so. Half of the respondents who'd been prescribed an opioid said they didn't use all their pills, and 86

percent said they kept leftover opioids for later potential use. According to Alison Bryant, senior vice president of research for AARP, "The fact that so many older adults report having leftover opioid pills is a big problem, given the risk of abuse and addiction with these medications." Bryant explained that "having unused opioids in the house, often stored in unlocked medicine cabinets, is a big risk to other family members as well. These findings highlight the importance of improving older adults' awareness and access to services that will help them safely dispose of unused opioid medications." More information The U.S. National Institute on Drug Abuse has more about prescription opioids.

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August 5, 2018 RI ARA E-Newsletter  

August 5, 2018 RI ARA E-Newsletter  

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