Jan 29, 2024
Dr. Fiona Elwood, VP and Neurodegeneration Disease Area Stronghold leader at J&J Innovative Medicine discusses the challenges in developing new therapies for neurodegenerative diseases in part because of the heterogeneity of the patient population. She highlights the difficulty in defining the subsets of these diseases and identifying the right patients for clinical trials. Emphasizing the importance of early detection, J&J Innovative Medicine is developing strategies to support the move to precision medicine in treating diseases like Alzheimer's and Parkinson's to prevent patients from moving to a symptomatic stage of disease.
Fiona explains, "For example, in Alzheimer's disease, as many people know, one of the primary symptoms is dementia, but dementia is a symptom. There can be other reasons why people develop forms of dementia. Alzheimer's disease is a specific disease where now we know patients can be defined by the pathology in the patient's brain. So specifically, the patients develop amyloid plaques, extracellular clumps or plaques of the amyloid beta peptide, and intracellular, inside neurons, tangles of a protein called tau. So, it's these pathological hallmarks that characterize or define Alzheimer's disease and lead to symptoms such as dementia."
"We know that Alzheimer's, for example, starts about ten years before patients display symptoms. But we don't know exactly how quickly each person might progress or the specific subset of symptoms that each patient may be particularly susceptible to."
"Then maybe the third thing I'll call out that's been a real challenge to us has been the time course of disease and the fact that the Alzheimer's pathology can start 10, 20 years before patients show up at their doctor's office. Historically, we weren't able to detect those very earliest stages of disease. Now, because of the field's investment in different biomarker technologies, imaging technologies, digital technologies, and even highly sensitive blood-based screening technologies, we can identify patients right at the beginning of that pathological cascade."
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