What's the problem?
Dementia is amongst the top ten causes of death and more than 55 million people have dementia worldwide. In Europe, the number of deaths related to dementia rises every year, with more than 250 000 deaths in 2020. The societal burden of neurodegenerative diseases is heavy, impacting patients, their families and public healthcare systems over decades. There is no cure, and treatments for symptoms may only work for some people, usually for a short period. Patients with dementia often have co-morbidities which give rise to complexities in terms of therapeutic care. Clinical trials tend to have a high failure rate, especially at the late stages, there is a lack of understanding of the underlying disease mechanisms, and translating laboratory findings into new treatments has proven difficult.
What are we doing about it?
The Innovative Health Initiative (IHI)’s first call for proposals sought the development of a decision-support system to support a more holistic approach to treating patients with neurodegenerative diseases. The Innovative Medicines Initiative (IMI) has funded over 20 projects in this area, accounting for around 10% of the budget. Most of the IMI projects also focus on Alzheimer’s disease, the most prevalent cause of dementia, but we also have projects that deal with other dementia-causing conditions such as Parkinson’s and Huntington’s disease.
The projects cover the whole spectrum of medical research and drug development, and patients play an active role in many projects, bringing their experience of their disease to the table.
Given the complexity of the brain and nervous system, it is unsurprising that many of our projects are unravelling the role of specific genes and proteins in disease. Other projects are exploring ways of identifying people at greatest risk of developing dementia and on how to improve diagnosis, management and development of novel treatments. We also have projects applying a ‘big data’ approach to progress in the area as well as investigations into personalised approaches to managing neurodegeneration.
IHI / IMI research is...
|...translating scientific findings into new treatments||
ADAPTED, IMPRIND and PHAGO have made important discoveries about the function of the APOE gene, the key mechanisms involved in tau protein misfolding and neuroinflammation, translating their findings into new tools, assays and platforms. EQIPD developed a wiki-based quality system to help increase adherence to rigorous, evidence-based practices in preclinical research helping to cut down on the high failure rate in trials of potential dementia drugs.
|…categorising dementia into different subtypes|
|…reducing the high failure rate of clinical trials of dementia drugs||Biomarkers identified by EMIF-AD have improved patient selection for trials, as have social functioning clues from personal devices (PRISM). RADAR-AD's digital platform can track changes in cognitive and functional abilities and EPAD's platform makes enrolment in clinical trials more efficient. AMYPAD's platform is studying the optimal use of β-amyloid PET imaging for more better and cheaper trials, and AETIONOMY created ‘Virtual Patient Cohorts’.|
|…generating invaluable resources and infrastructure to feed future research||EPAD, AETIONOMY and ADAPTED generated invaluable datasets and biobanks for Alzheimer’s research. . EBiSC2 has made more than 900 human-inducible pluripotent stem cells (hiPSC) available, including many from people with dementia. EPAD's Trial Delivery Centres is a connected and certified network of sites that are qualified to run Alzheimer’s clinical trials. ROADMAP created an interactive data visualisation tool that synthesises data sources from around Europe, while the EPAD Academy and EQIPD training modules trained a new generation of researchers, and the Decision Tool from NEURONET helps researchers engage with regulatory and HTA bodies.|
|…leveraging big data and AI to deliver personalised approaches to diagnosis||The IHI PROMINENT project will draw on existing AI tools to develop a digital platform that will improve the diagnosis and personalised treatment of Alzheimer’s disease. AETIONOMY developed computer simulations that will help us to better understand how a brain slides into dementia.|