a4 stands for anti amyloid treatment in asymptomatic alzheimers disease
the study uses an antibody made by eli lilly called solanezumab
this solanezumab works similar to my drug aducanumab by going into the spinal fluid that bathes the brain and spinal cord and into the brain to remove the amyloid that accumulates in folks usually years before symptoms of alzheimers starts
here is a link to the a4 study website
the hope is by removing the amyloid that this may slow down alzheimers symptoms
this a4 study is a long term study that will probably last for several years
after biogen increased the dose on aducanumab in my study and saw results that looked promising
then
eli lilly increased to a higher dose of solanezumab in the a4 study
this a4 study is the first treatment study i tried to enter
i was turned down because
they were only looking for folks who were having no symptoms but who had positive amyvid pet scans for amyloid in the brain
these folks have prealzheimers or prodromal alzheimers
i had mild memory issues at that time and was on aricept (donepezil) so i wasnt allowed in the a4 study
in the theory of what goes on as we develop alzheimers
amyloid accumulates first
then
tau proteins inside the nerve cells in the brain unwind and get released as tangles
both the amyloid and the tangles cause brain cell death
then
the body attacks these areas and an inflammatory reaction occurs in the brain causing more destruction
solanezumab attacks just amyloid
my drug aducanumab attacks amyloid and seems to also reduce tau tangles and maybe reduces inflammation some
the preliminary results of the a4 study linked here showed that this higher brain amyloid in patients who were asymptomatic was associated with a family history of alzheimers and at least one apoe 4 gene and showed that these folks had subtle cognitive or memory issues even early on
these folks are at higher risk and are good candidates for early treatment with drugs like solanezumab or probably aducanumab and other similar drugs during this prealzheimers time
so if you had looked at me when i was in my mid 50s i had prealzheimers
my amyloid levels would have been elevated if i had had a amyvid pet scan for amyloid at that time
i of course have the double apoe 4 gene associated with an increased risk of 10-20 times that i will get alzheimers
i have a strong history of alzheimers disease in my family
my mother and younger brother died with it
my father probably had it when he died
my older brother may have it
multiple aunts and uncles had it
etc etc
if i had had a good neuropsychological exam done at that time probably there would have been subtle changes on my short term memory on this lengthy memory testing
memory testing for my long term insurance at 57 was normal but it was more like the in office memory testing like the mmse test
so the question is
will taking a drug like solanezumab months to years before symptoms start slow down or stop the progression of alzheimers disease
hopefully this a4 study will eventually answer that question
my drug adcuanumab is probably going to be doing a study like the a4 study where folks who have prealzheimers or prodromal alzheimers will begin taking aducanumab months before symptoms start
this along with life style modifications will be how we slow down this disease or hopefully prevent it all together
the biogen aducanumab study that i am suppose to restart in may most likely will get delayed by the convid 19 pandemic
we are waiting to hear soon about its status
the organicgreen doctor
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