Samantha Benham-Hermetz, Director of Policy and Public Affairs at Alzheimer’s Research UK charts us through the priorities for dementia research in the UK in light of COVID-19
During the last year, people with dementia have been disproportionately affected by the COVID-19 pandemic. In fact, a quarter of people who have died from COVID-19 also had dementia. But the pandemic has also had massive implications for medical research. During lockdown, labs were closed with much work temporarily put on hold.
Dementia research during the pandemic
Even as I write, labs conducting vital dementia research are not all open at 100% capacity and we don’t know how further regional or national restriction measures may impact the ones currently open. Social distancing in specialised lab environments is difficult and getting clinical trials up and running again with volunteers at high risk of COVID-19 is challenging. Fixed-term contracts, all too common in medical research, mean that vital research staff, particularly those in the early stages in their careers, are at greatest risk of job losses. In fact, a recent survey revealed that one in three dementia researchers are considering leaving research because of COVID-19. All at a time where funders across the UK struggle to honour commitments.
As a dementia research charity, we are facing up to a 45% shortfall in income because of COVID-19. The pandemic is not only affecting our ability to fund new research this year, but has the potential to alter the landscape of dementia research for years to come.
What has not changed is our vision of a world without the fear, harm, and heartbreak of dementia. And we are committed to redoubling our efforts just as soon as we are able.
Why? Because dementia is a devastating and progressive condition that is not just going to go away. While we have seen a great deal of progress in dementia research over the last 10 years, we do not yet have a drug that stops or even slows one of the many diseases, like Alzheimer’s, that cause it. And the further impact of COVID on people with dementia means breakthroughs have never mattered more.
Life-changing new treatments ahead
However, there is hope and life-changing new treatments are in our sights. We expect to see the outcomes of an FDA priority review of the potential Alzheimer’s drug, aducanumab in March 2021. This will determine whether it is licensed in the U.S., but for the UK, we will have to wait longer and see whether there is sufficient evidence that aducanumab is safe and clinically effective to receive regulatory approval. We are close to a treatment, but there’s work still to do, and we must prepare.
While this would be such a positive step forward for people with dementia and our field, aducanumab is unlikely to be a panacea. Any newly licensed drug would still need to be judged to be cost-effective by NICE. And, as many of the experimental drugs in late stage clinical trials are thought to be most effective for people at the earliest stages of Alzheimer’s, a new diagnostic pathway would need to be developed so that beneficiaries could be identified and treated to delay the progression of this devastating disease. New drugs, therefore, won’t be available to everyone and won’t work for all the diseases that cause dementia, so we still need to fast-track the development of a wide range of new treatment options. The UK is home to the Alzheimer’s Research UK Drug Discovery Alliance, which houses scientists in state-of-the-art facilities doing exactly this. With over 30 approaches underway to tackle the diseases that cause dementia, they are at the centre of multiple collaborations with industry and universities – bringing together expertise from across the UK and around the world.
The biology underpinning the diseases that cause dementia are complex. Despite all the challenges, work to understand promising areas of research continues. The immune system, which is the body’s defence mechanism, safeguarding against damage and attack is one such area that’s previously received less attention.
It’s also an area where new treatments may arise. New start-up companies like AstronauTx, will start to look to develop new medicines designed to reset the behaviour of crucial support cells in the brain. The drug discovery process is like finding the right key for a lock and the search for new treatments is ongoing.
It’s likely that any new treatments in the pipeline will need to be given as early as possible. The diseases that cause dementia start in the brain decades before symptoms begin to show. Currently, we can only diagnose someone with a disease that causes dementia when someone shows symptoms, which means treatments have a much harder job to do at this later stage.
Technology for neurodegenerative diseases
Advances in technology are providing huge opportunities to intervene decades earlier, when these diseases first start to take hold. That’s where the Early Detection of Neurodegenerative Diseases (EDoN) initiative comes in.
This ambitious project is pulling together a wealth of information from a huge number of studies that will ultimately allow us to develop and test a digital device designed to pick up subtle clues of disease in people who don’t yet have any obvious symptoms of dementia.
Identifying the very earliest changes in these diseases would transform research efforts today, giving us the best chance of treating or preventing these diseases before the symptoms of dementia start to get in the way of life.
The future of dementia research funding in the UK
In COVID-stricken 2020, research is at risk, but there is hope. The UK government committed to double funding for dementia as a part of their manifesto pledge. They must follow through with this and deliver funds for life-changing dementia research. We cannot risk losing a generation of researchers and progress across the field. To sign the petition, visit https://www.alzheimersresearchuk.org/how-you-can-help/campaign/
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