To Treat or Not To Treat

Currently, neurologists are testing preventative therapies on patients who are in the advanced stages of Alzheimer’s. Here’s the problem: These strategies weren’t designed to be effective in these patients.

Here’s another way to think of it : Would you test statins – drugs commonly used to prevent heart disease – in patients who have already suffered massive heart attacks?

Even if a preventative therapy were effective, it probably wouldn’t show in the volunteers currently in the trials.

In a recent “Perspective” article in the journal Neuron, University of Florida researcher Todd Golde points out the discontinuity between studies in humans, which look at treatment, and preliminary laboratory studies, which concentrate on prevention.

He told me there are ethical issues with giving experimental preventative drugs to human patients with no sign of disease.

“When we consider prevention, a drug or a therapy has to be deemed ‘safe,’” Golde says. “The bar for that is set pretty high, especially if you’re dealing with asymptomatic people.”

He says Alzheimer’s research should focus on identifying substances in the body that could signal the likelihood people would develop the disease. This may resolve the ethical issue, since scientists could then identify volunteers before they show symptoms. []