New drug shows promise for Alzheimer’s disease and dementia
A Monash University-led study, published in Alzheimer’s and Dementia: Translational Research and Clinical Interventions, has found a promising new treatment for patients with the second most common form of dementia in people aged under 60 years, resulting in a stabilising of escalating behavioural issues, and a reversal of brain shrinkage due to the disease. It is the second clinical trial to show that the drug, sodium selenate, may be slowing cognitive decline and neurodegenerative damage that is the hallmark of Alzheimer’s disease and dementia. Behavioural variant frontotemporal dementia (bvFTD) can occur in people as young as 35 years of age. It is characterised by behavioural disturbances and personality changes and can be highly disruptive and distressing for both patients and their families. There are no treatments or cures for bvFTD and typical survival is 5–7 years from diagnosis. The Monash phase 1 trial showed that sodium selenate is safe and well tolerated in patients with bvFTD over a period of 12 months. The majority of patients receiving sodium selenate showed no change in their cognitive or behavioural symptoms and reduced rates of brain atrophy over the trial period. In almost half of the cases with bvFTD, the damage to the neurons in the brain is caused by the build-up of a protein called tau. According to the study authors, sodium selenate upregulates an enzyme in the brain that effectively attacks the tau protein. In addition, those patients in the trial with higher levels of selenium, a breakdown product of sodium selenate, in their bloodstream showed less cognitive decline. The research group is now conducting a larger study at many hospitals across Australia and New Zealand to further test whether this drug is beneficial for patients with bvFTD.
In-house pharmacists essential for aged care
Research from the University of South Australia, published in Age and Ageing, shows that regular visits from pharmacists to aged-care residents can reduce problems due to medicines and improve health outcomes. Working with 248 aged-care residents across 39 aged-care facilities in South Australia and Tasmania, researchers assessed the effectiveness of a pharmacist-led intervention. Over 12 months, pharmacists met with residents every 8 weeks to record any new illnesses or conditions and to monitor any adverse effects or symptoms. They also reviewed participants’ medicines and monitored cognitive and physical health. The study found that regular pharmacist visits were important. At each visit, pharmacists found 60% of residents had problems with their medicines. They made 309 recommendations to change residents’ medications or monitor their medications with a view to change; and, for almost two-thirds of the population, recommended reduced medicine use. Importantly, the study showed a significant change in participants’ cognition scores, with those monitored by pharmacists, less likely to experience negative effects. The Australian Government, who funded the research, recently announced funding for on-site pharmacists to improve medication management in government-funded aged-care facilities, commencing in January 2023.
Obesity associated with a higher risk of fatal prostate cancer
A meta-analysis from the University of Oxford, published in BMC Medicine, has linked body fat (adiposity) with risk of fatal prostate cancer. The association didn’t just apply to belly fat, however, with the rise in risk similar for overall body fatness. The meta-analysis included data on 2.5 million men from 19 studies, as well as data from a new analysis from more than 200 000 men in the UK Biobank study. All of the studies included in the meta-analysis were prospective, meaning men who were free of prostate cancer at the start of the study were followed for many years and the number of deaths from prostate cancer during that time logged. Adiposity was measured at the start of each study, with up to four different measures used: body mass index (BMI), waist circumference, waist to hip ratio, and body fat percentage. Higher amounts of body fat (adiposity) were linked to higher likelihood of fatal prostate cancer. Every five-point increase in BMI was found to increase the risk of dying from prostate cancer by 10%, while a 5% increase in total body fat percentage raised the risk by 3%. The risk was similarly increased for central adiposity. Each 0.05 increase in waist to hip ratio increased the risk of fatal prostate cancer by 6%. And every 10 cm increase in waist circumference increased the odds by 7%. The researchers calculated that there would be around 1300 fewer prostate cancer deaths a year in the UK if the average BMI in men was five points lower.
Victorians wanted for trial of lower-dose COVID-19 booster shots
The Murdoch Children’s Research Institute (MCRI) is looking for 800 Victorians aged 18 years and over who have not yet received a COVID-19 vaccine booster for a trial investigating whether vaccinating people with a lower COVID-19 booster dose is just as effective as a full dose but with fewer side effects. The findings are expected to provide important data on the potential merits of vaccinating people with reduced booster doses of the COVID-19 vaccine — as opposed to a full booster dose — with the aim of increasing access to COVID-19 vaccines. Recruits would receive either the Pfizer or Moderna vaccine and be followed for up to 12 months. Up to 3800 healthy participants will be invited to take part in the trial across Australia, Indonesia and Mongolia. The Coalition for Epidemic Preparedness Innovations (CEPI) will provide up to $12.3 million in funding to the global trial led by the MCRI in collaboration with Padjadjaran University and the University of Indonesia in Indonesia, and the Government of Mongolia. The study is the first under CEPI’s program of work looking at reduced COVID-19 booster shots. In line with CEPI’s access policy, access to the trial data will be shared through open-access publications and via scientific meetings to ensure all can benefit from the research findings. Participants in Victoria would be required to visit the Royal Children’s Hospital for four blood tests, complete an online diary card for seven days after vaccination and receive three follow-up calls. For more on the trial, visit www.mcri.edu.au/research/projects/cepi-covid-19-booster-study or email COVID.Booster@mcri.edu.au