Summary: A study analyzing data from more than 130 million people found that antibiotics, antivirals, vaccines and anti-inflammatory drugs are associated with a reduced risk of dementia. This supports the idea that infections and inflammation contribute to dementia and highlights the potential for repurposing existing drugs for prevention or treatment.
Although some medications, such as blood pressure medications, have shown mixed results, researchers emphasize that the effects of medications vary and require further research. Accelerating trials of repurposed drugs could lead to faster, more cost-effective solutions for dementia care. The study highlights the importance of pooling large data sets to prioritize treatments for clinical trials.
Key facts:
- Reused medications: Antibiotics, antivirals, vaccines, and anti-inflammatory medications are associated with a lower risk of dementia.
- Infection connection: The findings support theories linking bacterial and viral infections to dementia.
- Faster testing: Safety profiles of existing drugs could speed up trials and reduce costs.
Source: University of Cambridge
Antibiotics, antivirals, vaccines and anti-inflammatory drugs are associated with a reduced risk of dementia, according to a new study looking at health data from more than 130 million people.
The study, led by researchers from the Universities of Cambridge and Exeter, identified several drugs already licensed and in use that could potentially be repurposed to treat dementia.
Dementia is one of the leading causes of death in the UK and can cause profound distress to the individual and those who care for them. Its global economic cost is estimated to exceed $1 trillion.
Despite intensive efforts, progress in identifying drugs that can slow or even prevent dementia has been disappointing. Until recently, dementia medications were only effective on symptoms and had a modest effect.
Lecanemab and donanemab have recently been shown to reduce the buildup of amyloid plaques in the brain – a key feature of Alzheimer’s disease – and slow the progression of the disease, but the National Institute for Excellence in Health and Care Agency (NICE) concluded that the benefits were insufficient to justify approval for use within the NHS.
Scientists are increasingly looking to existing drugs to see if they can be repurposed to treat dementia. As the safety profile of these drugs is already known, the move to clinical trials can be significantly accelerated.
Dr Ben Underwood, from the Department of Psychiatry at the University of Cambridge and Cambridgeshire and Peterborough NHS Foundation Trust, said: “We urgently need new treatments to slow the progression of dementia, or even prevent it.
“If we can find drugs that are already approved for other conditions, we can then put them into trials and, most importantly, make them available to patients much more quickly than we would for a completely new drug. new.
“The fact that they are already available is likely to reduce costs and therefore make them more likely to be approved for use in the NHS.”
In a study published today in Alzheimer’s and dementia: translational research and clinical interventionsDr Underwood, in collaboration with Dr Ilianna Lourida from the University of Exeter, led a systematic review of existing scientific literature to look for evidence of prescription medications modifying the risk of dementia.
Systematic reviews allow researchers to combine multiple studies that may have weak or even conflicting evidence to arrive at stronger conclusions.
In total, the team reviewed 14 studies using large clinical datasets and medical records, capturing data from more than 130 million individuals and 1 million cases of dementia. Although they found a lack of consistency across studies in identifying individual medications affecting dementia risk, they identified several drug classes associated with altered risk.
An unexpected finding was an association between antibiotics, antivirals and vaccines and a reduced risk of dementia. This finding supports the hypothesis that common dementias may be triggered by viral or bacterial infections, as well as recent interest in vaccines, such as the BCG vaccine against tuberculosis, and in reducing the risk of dementia.
Anti-inflammatory medications such as ibuprofen have also been found to be associated with reduced risk. Inflammation is increasingly seen as an important contributor to a wide range of diseases, and its role in dementia is supported by the fact that some genes that increase dementia risk are part of inflammatory pathways.
The team found conflicting evidence for several classes of medications, with some blood pressure medications and antidepressants and, to a lesser extent, diabetes medications being associated with reduced risk of dementia and others associated with increased risk. increased.
Dr Ilianna Lourida from the National Institute for Health and Care Research Applied Research Collaboration South West Peninsula (PenARC), University of Exeter, said: “Because a particular medication is associated with an altered risk of dementia, this does not mean necessarily that he causes or even helps with dementia.
“We know that diabetes increases the risk of dementia, for example, so anyone taking medication to manage their glucose levels would naturally also be at higher risk of dementia – but that doesn’t mean the medication increases your risk.
“It is important to remember that all medications have benefits and risks. You should never change medications without first discussing it with your doctor, and you should speak to your doctor if you have any concerns.
The conflicting evidence may also reflect differences in how certain studies were conducted and how data were collected, as well as the fact that different drugs, even within the same class, often target different biological mechanisms.
The UK Government is supporting the development of an Alzheimer’s disease trials platform to evaluate medicines quickly and efficiently, including repurposed medicines currently used for other conditions.
“Bringing these huge health data sets together provides a source of evidence that we can use to help us focus on which drugs we should try first,” Dr. Underwood said. “We hope this will help us find much-needed new treatments for dementia and speed up the process of getting them to patients.”
About this research news in neuropharmacology and dementia
Author: Craig Brierley
Source: University of Cambridge
Contact: Craig Brierley – University of Cambridge
Picture: Image is credited to Neuroscience News
Original research: Free access.
“Data-driven discovery of associations between prescribed medications and dementia risk: a systematic review” by Ben Underwood et al. Alzheimer’s and dementia: translational research and clinical interventions
Abstract
Data-driven discovery of associations between prescribed medications and dementia risk: a systematic review
Recent clinical trials aimed at slowing the progression of dementia have led to a renewed focus on finding safer and more effective treatments. One approach to identifying plausible candidates is to assess whether existing medications for other conditions may affect dementia risk.
We conducted a systematic review to identify studies taking a data-driven approach to investigating the association between a wide range of prescribed medications and dementia risk.
We included 14 studies using administrative or medical record data for more than 130 million people and 1 million cases of dementia. Despite inconsistencies in identifying specific medications that may modify risk for Alzheimer’s disease or dementia, some themes emerged for drug classes with biological plausibility.
Antimicrobials, vaccines, and anti-inflammatories were associated with reduced risk, while diabetes medications, vitamins and supplements, and antipsychotics were associated with increased risk.
We found conflicting evidence for antihypertensives and antidepressants. Repurposing dementia medications is an urgent priority.
Our results provide a basis for prioritizing candidates and exploring underlying mechanisms.
