Ongoing trials in Alzheimer's disease

Researchers have sought to understand the underlying pathophysiology of Alz heimer's disease (AD) ever since Dr A Alzheimer first described the conditi on in 1907. Unfortunately however, until recently, they have done so with l imited success. This lack of clarity has deterred advancements in therapeut ic drug research beyond all but the purely symptomatic treatment relief cur rently available. However, through spatio-temporal analysis of the two type s of cerebral lesions that characterise the disorder (senile plaques and ne urofibrillary tangles) and the compilation of genetic data concerning famil ial AD, there now exists the foundation for a more comprehensive understand ing of the disease. Although symptomatic cholinergic strategies have benefi cial effects, their benefits are modest and current research has turned to the development of other promising strategies, including oestrogen replacem ent, anti-inflammatory agents, free radical scavengers, anti-oxidants and m onoamine oxidase-B (MAO-B) inhibitors. Many of these strategies may have so me merit, however further analysis and structured research are necessary be fore a definitive decision can be made about their efficacy and possible ro le in AD therapy. Strategies that are directed at halting the underlying bi ochemical changes in AD are nearing clinical testing and offer the promise for meaningful therapeutic outcomes.