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DESPITE decades of work and hundreds of trials, Alzheimer鈥檚 disease remains an end-of-life trauma for millions. Could that be about to change? Although there is still no way to reverse or cure the condition, a small clinical trial in 33 people with Alzheimer鈥檚 suggests that a drug already widely used to treat rheumatoid arthritis might be able to delay or even halt its progression.

A new therapy is desperately needed. A 2012 report by the World 91色情片 Organization estimated that, . The few existing treatments only ease symptoms and slow the progression of the disease, and new candidate drugs are failing clinical trials. Between 2002 and 2012, 413 trials of drugs for Alzheimer鈥檚 disease were conducted, but 99.6 per cent of them failed ().

Now, preliminary results from a pilot trial suggest that a drug used to treat arthritis could have the potential to halt the progression of Alzheimer鈥檚.

Over six months, people with mild-to-moderate Alzheimer鈥檚 taking a placebo showed expected cognitive decline, but those taking the drug, called etanercept, had similar scores in some tests for cognitive function at the end as they did at the start of the trial.

In other tests for cognition, behaviour and coping, the symptoms of those taking the drug either stabilised or declined to a lesser degree than those of people taking a placebo.

鈥淲e saw exactly what we hoped we would, and no one has shown these effects before,鈥� says of the University of Southampton, UK, who presented the results at the in Copenhagen, Denmark, on Wednesday. 鈥淭here鈥檚 always the proviso,鈥� he adds, 鈥渢hat it must be done in larger numbers of patients in a bigger study, over a year, not six months.鈥�

聯We saw exactly what we hoped we would, and no one has shown these effects before聰

The work is being regarded as promising by other researchers, nonetheless. 鈥淭he results of this small-scale study are fascinating and exciting as they offer proof of principle,鈥� says Robert Dantzer of the MD Anderson Cancer Center in Houston, Texas, who studies how the immune system affects illness. 鈥淧atients treated with etanercept were essentially stabilised, while the placebo-treated patients continued to deteriorate, slowly but surely.鈥�

聯Patients given etanercept stabilised; those given a placebo deteriorated, slowly but surely聰

Etanercept works by sponging up and disposing of a protein called TNF-alpha, which ramps up and sustains inflammation following infections or as a result of metabolic or inflammatory diseases including diabetes. The drug is prescribed as a weekly injection for people with arthritis.

In 2010, Richard Chou鈥檚 team at the Dartmouth-Hitchcock Medical Center in Lebanon, New Hampshire, compared the health records of people with Alzheimer鈥檚 and arthritis with those of people with arthritis but not Alzheimer鈥檚. They found that .

That might be because inflammation outside the brain has knock-on effects inside it, aggravating and accelerating dementia and brain degeneration if those processes have already begun. Earlier this year, Holmes and his colleague Hugh Perry uncovered how inflammatory molecules made by white blood cells can initiate a process that results in the death of brain cells.

鈥淭he rationale that inflammation from other diseases such as arthritis, diabetes, atherosclerosis and infections contributes to Alzheimer鈥檚 disease progression is well-founded scientifically,鈥� says Colm Cunningham of Trinity College Dublin in Ireland, who helped Perry piece together the mechanism by which inflammation elsewhere in the body affects disease in the brain. Tackling some of these conditions could help fend off Alzheimer鈥檚 (see 鈥�Protect yourself鈥�).

Of the 33 people with mild-to-moderate Alzheimer鈥檚 disease participating in Holmes鈥檚 trial, 18 received weekly injections of etanercept, while 15 were given a placebo of weekly saltwater injections, for six months. At the start, middle and end of the trial, a host of tests of the participants鈥� cognition, behaviour and well-being were carried out by assessors unaware of which volunteers had received treatment.

The main objective of the small study was to check that the treatment was safe and well-tolerated by people with Alzheimer鈥檚 disease. But Holmes鈥檚 team found that the participants taking etanercept performed comparatively better on memory, behaviour and well-being tests, although there was no statistically significant difference in their performance on other tests of cognition and depression (see 鈥�A measured effect鈥�).

In a small pilot study like this, the success of the drug could be down to chance, says Holmes. 鈥淏ut the results are very consistent, and the big Alzheimer鈥檚 trials that have been performed on thousands of patients have not shown anything like it.鈥�

Other researchers warn that doing larger studies is paramount before people get excited about etanercept鈥檚 potential. 鈥淭rials like this are not big enough to tell whether the drug works, but rather to check the drug is safe, and it is,鈥� says of University College London. 鈥淎nalysing the data suggests there may have been an improvement, but the study is about a tenth the size we would need to draw a conclusion about whether the drug slows disease progression.鈥�

Holmes says expanding to larger trials would be relatively simple because the drug has a proven track record. 鈥淲e know a lot about it, and it鈥檚 already out there for arthritis,鈥� he says. 鈥淚t could move very quickly, and within maybe two to three years we would be there.鈥�

鈥淚t鈥檚 certainly worth following up with a larger study,鈥� says Eric Karran, director of research at the charity Alzheimer鈥檚 Research UK. 鈥淐onsidering the small size of the trial, it鈥檚 very promising to see positive effects on measures of memory and thinking, behaviour and day-to-day activities, and for these to get stronger with time.鈥�

This article appeared in print under the headline 鈥淒rug stalls attack of Alzheimer鈥檚鈥�