Aged Care Insite Issue 131 Jun-Jul 2022 | Page 4

news

Alzheimers breakthrough ?

Xanamem shows promise but questions over its effectiveness remain .
By Elise Hartevelt

A local biotech company thinks it may have found the future drug to treat Alzheimer ’ s disease .

Australian firm Actinogen recently announced that its latest trial of the drug Xanamem had shown improved attention and working memory in Alzheimer ’ s patients .
CEO Dr Steven Gourlay said that “ it ’ s a big step closer to creating a novel treatment for a disease that impacts over 400,000 elderly Australians ”.
“ We ’ ve shown that we have the cognitive-enhancing ability , meaning that working memory and attention improve within two weeks of taking the drug , which is wonderful ,” Gourlay said .
“ Xanamem has the potential to be a novel daily oral therapy for Alzheimer ’ s disease and other conditions that could be safely used alone or in combination with other therapies .”
Unlike most drugs on the market which focus on the neurotransmitter acetylcholine , Xanamem targets the hormone cortisol in the brain .
Cortisol regulates many functions in the body , ranging from metabolism to the immune response , yet its primary function is regulating stress .
“ Cortisol is a normal hormone in the body each cell needs to help keep it alive ,” Gourlay explained .
“ But excessive cortisol levels are associated with ( abnormal ) ageing and damage to the brain , particularly areas involved in memory and thinking that are associated with Alzheimer ’ s disease .
“ The drug reduces cortisol levels inside cells in the brain , where it helps to improve working memory and attention , but without lowering these cortisol levels you need in your blood or your tissues elsewhere in the body .”
However , studies involving drugs that target cortisol to treat Alzheimer ’ s are very limited .
Aged Care Insite spoke with Scientia Professor Perminder Sachdev from UNSW Sydney University about the trial ’ s results , who questions the trial ’ s hypothetic framework .
“ It ’ s not a central hypothesis for Alzheimer ’ s disease : it ’ s a peripheral hypothesis ,” he says .
“ And because it ’ s not a central hypothesis in Alzheimer ’ s disease , you ’ re tinkering on the edges , really .
“ There ’ s some data that cortisol levels

It ’ s not a central hypothesis in Alzheimer ’ s disease , you ’ re tinkering on the edges .
are higher in people with Alzheimer ’ s , but whether that ’ s primary or secondary to the disease itself , we don ’ t know .”
He points out that the study is still in its early stages and only trialled Xanamem for a short period .
Usually , Alzheimer ’ s studies are much longer .
“ You don ’ t do studies for 12 weeks and then say you have a breakthrough unless you have dramatic facts ,” Sachdev said . “ The study may have statistically significant results , but is it clinically significant ? “ For a definitive study , they need to go to Phase Three studies and have a longer trial .”
Gourlay said that “ it is a scientific breakthrough ” in the sense that they ’ ve proven the relevance of inhibiting cortisol via this target in the brain , not just once but twice .
“ And the next steps are , of course , to develop clinical trials that use a bigger population , more patients , and then consolidate the findings .
“ But I think calling it a breakthrough is still fair .”
Gourlay plans to set up a series of clinical trials over the next two to three years to further test Xanamam ’ s potential to treat Alzheimer ’ s disease . ■
2 agedcareinsite . com . au