Experimental therapies being developed as a disease modifying therapy for Alzheimer’s disease have largely focused on preventing the build-up of amyloid plaques to slow disease progression. EIP Pharma is charting a new course – focused on reversing the synaptic dysfunction that in the early stages, regardless of cause, underlies the memory deﬁcits seen in Alzheimer’s.
The Role of Synaptic Dysfunction in Alzheimer’s Disease
The brain has billions of neurons, and each one connects to other neurons in the brain through synaptic connections. In the past ﬁve years, scientists have found that the synapse is a convergence point for amyloid beta, tau and inﬂammation, all of which have been linked to synapse toxicity and either the onset or progression of disease.
Evidence suggests that synaptic dysfunction could be the fundamental pathologic event within the neuron that causes memory deficits – the defining characteristic of the disease. Synaptic dysfunction is reversible in animal models, suggesting that therapeutics targeting synaptic dysfunction have the potential to reverse memory deﬁcits. EIP Pharma is aiming to treat synaptic dysfunction to both slow and potentially reverse disease progression in the early stages of Alzheimer’s disease.
p38 alpha – A Driver of Synaptic Dysfunction
p38 alpha is an enzyme that is activated in neurons in times of stress and disease. While p38 alpha plays an important role in protecting cells from acute injury, chronically activated p38 alpha activity within neurons can damage synapses and lead to synaptic dysfunction. If untreated, synaptic dysfunction continues to progress, resulting in the loss of neurons.
EIP Pharma is developing an oral p38 alpha inhibitor, neﬂamapimod, to reverse synaptic dysfunction in the basal forebrain cholinergic system. Degeneration in this system is an important contributor to disease expression and progression in patients with early-stage Alzheimer’s disease. We’ve conducted two phase 2a studies and one phase 2b study of neﬂamapimod in patients in the early stages of symptomatic Alzheimer’s disease and found that the drug potentially reverses synaptic dysfunction and improves episodic memory, or a person’s ability to create memories of new events and activities. Examples of episodic memory can include where you parked your car, where you placed your keys or whether you took your medication.
The results from the phase 2b study to evaluate neflamapimod in early Alzheimer’s patients have been published. In that study, neflamapimod demonstrated target engagement, with significant reduction relative to placebo in CSF p-tau and tau and also suggested that cognition was improved in patients with the highest levels of drug in their blood.
A phase 2 double-blind placebo-controlled 24-week treatment clinical study of neflamapimod in mild Alzheimer’s disease
Resources for Patients and Caregivers
MORE ABOUT THE DISEASEAlzheimer’s Foundation
National Institute on Aging (NIH)
Inside the Brain – How the Mind Works
EXPANDED ACCESSExpanded Access Policy
SUPPORT GROUPSFamily Caregiver Alliance
NIH Caregiver’s Guide
Well Spouse Association
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"Often when people think of neurodegeneration they look toward the end of the process, which is characterized by neuron death and loss. But in fact, neurodegeneration is a long and complex process that we now know much of the time ahead of neuron death is driven by synaptic dysfunction and deterioration in a broad range of neurodegenerative diseases. In animal models, we and others have shown that if you treat synaptic dysfunction at the early stages of disease, you’re able to restore synaptic function and prevent neuron death, giving us new hope and optimism for treating dementia with Lewy bodies and other neurological disorders where synaptic dysfunction in the basal forebrain cholinergic system contributes to disease expression and progression."