Neuroprotective Drugs for Alzheimer Disease: Howard Fillit, MD

WATCH TIME: 5 minutes

“I think neuroprotection is an increasingly interesting area because there's so many ways that the brain can be injured, and with no protection, it's kind of regardless of the pathway of injury. We can help to slow the rate of progression with these neuroprotective drugs.”

Discussing areas that may be overshadowed by bigger headlines surrounding aducanumab (Aduhelm; Biogen) and other treatments, Howard Fillit, MD, founding executive director of the Alzheimer’s Drug Discovery Foundation, pointed to drugs that are in the neuroprotective class, namely riluzole, which is used for neuroprotective purposes in amyotrophic lateral sclerosis and has been repurposed for AD. Fillit also pointed to additional research in inflammation and metabolic research, as experts are seeing several drugs for diabetes providing evidence from epidemiological studies about decreasing risks for AD, particularly the glucagon-like peptide 1 agonists. 

The ongoing MET-FINGER (NCT05109169) trial will further evaluate metformin in the prevention of AD, with investigators led by Miia Kivipelto, MD, PhD, professor in clinical geriatrics, Karolinska Institutet, Center for Alzheimer Research; and senior geriatrician and director, Research and Development of Theme Aging, Karolinska University Hospital in Stockholm, Sweden. Kivipelto et al are conducting a large clinical trial, Fillit said, introducing lifestyle interventions and comorbidity management of diabetes and hypertension that have already demonstrated a slow in the rate of cognitive decline, with investigators hopeful about potential preventive effects with the addition of metformin.