Pioglitazone shows promise in treating Alzheimer's

Treatment of high blood sugar may have a scientific connection to memory loss that could, one day, benefit millions of people with Alzheimer's Disease, which affects up to 4.5 million older Americans, bringing with it impaired thinking and memory.

New research at the University of Virginia Health System and Case Western Reserve University shows that a drug approved by the Food and Drug Administration to treat type 2 diabetes may hold promise in treating Alzheimer's as well, without serious side effects. "We believe that the drug may reduce the body's inflammatory reaction to one of the toxic components that builds up in Alzheimer's, called amyloid plaque, " said Dr. David Geldmacher, an associate professor of neurology at UVa.

The drug, called pioglitazone HCl, was tested in a placebo-controlled trial involving 25 people with mild to moderate Alzheimer's. The study assessed the safety of the drug and, although the treatment appeared to reduce Alzheimer's progression, the study was too small for investigators to be sure of the effects on memory and everyday abilities. However, the findings are promising enough, researchers say, to carry out larger studies of pioglitazone.

The research was presented July 16 to the world's largest Alzheimer's conference, ICAD 2006, in Madrid, Spain. It was selected by ICAD organizers to be highlighted because of a growing sense of the relationship between diabetes and Alzheimer's.

"We don't know exactly how pioglitazone works in Alzheimer's, but there are two possibilities," Geldmacher said. "It could be that the drug reduces the body's response to the amyloid protein found in Alzheimer's. Or, it could be that this drug helps brain cells function. The real advantage is that it's a completely novel approach to treating the disease."

In the next few years, Geldmacher and his colleagues hope to study the effectiveness of pioglitazone in a group of 200 to 300 Alzheimer's patients nationwide. "If it works, this treatment might allow people to better hold on to memory and brain function over a period of time, despite having Alzheimer's," Geldmacher said. "It could also complement other treatments and become part of a multi-pronged approach to Alzheimer's treatment." Right now, there are 5 drugs approved by the FDA to treat Alzheimer's, Geldmacher said, but pioglitazone is unrelated to any of the others. The trial of pioglitazone at UVa and Case Western Reserve was supported by the National Institutes of Health and Takeda Pharmaceuticals North America, Inc., which manufactures the drug.