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Is Xanamem the Alzheimer’s breakthrough we’ve all been waiting for?

A local biotech company thinks it may have found the future drug to treat Alzheimer's disease. 

This week, Australian firm Actinogen announced that its latest trial of the drug Xanamem had shown improved attention and working memory in Alzheimer’s patients.

CEO Dr Steven Gourlay said that "it's a big step closer to creating a novel treatment for a disease that impacts over 400,000 elderly Australians".

"We've shown that we have the cognitive-enhancing ability, meaning that working memory and attention improve within two weeks of taking the drug, which is wonderful," Gourlay said.

"Xanamem has the potential to be a novel daily oral therapy for Alzheimer's disease and other conditions that could be safely used alone or in combination with other therapies."

Unlike most drugs on the market, which focus on the neurotransmitter acetylcholine, Xanamem targets the hormone cortisol in the brain.

Cortisol regulates many functions in the body, ranging from metabolism to the immune response, yet its primary function is regulating stress.

"Cortisol is a normal hormone in the body each cell needs to help keep it alive," Gourlay explained. 

"But excessive cortisol levels are associated with (abnormal) ageing and damage to the brain, particularly areas involved in memory and thinking that are associated with Alzheimer's disease.

"The drug reduces cortisol levels inside cells in the brain, where it helps to improve working memory and attention, but without lowering these cortisol levels you need in your blood or your tissues elsewhere in the body."

However, studies involving drugs that target cortisol to treat Alzheimer's are very limited.

Aged Care Insite spoke with Scientia Professor Perminder Sachdev from UNSW Sydney University about the trial's results, who questions the trial's hypothetic framework.

"It's not a central hypothesis for Alzheimer's disease: it's a peripheral hypothesis," he says. 

"And because it's not a central hypothesis in Alzheimer's disease, you're tinkering on the edges, really.

"There's some data that cortisol levels are higher in people with Alzheimer's, but whether that's primary or secondary to the disease itself, we don't know."

He points out that the study is still in its early stages and only trialled Xanamem for a short period. 

Usually, Alzheimer's studies are much longer.

"You don't do studies for 12 weeks and then say you have a breakthrough unless you have dramatic facts," Sachdev said.

"The study may have statistically significant results, but is it clinically significant?

"For a definitive study, they need to go to Phase Three studies and have a longer trial."

Gourlay said that "it is a scientific breakthrough" in the sense that they've proven the relevance of inhibiting cortisol via this target in the brain, not just once but twice.

"And the next steps are, of course, to develop clinical trials that use a bigger population, more patients, and then consolidate the findings. 

"But I think calling it a breakthrough is still fair."

Gourlay plans to set up a series of clinical trials over the next two to three years to further test Xanamam's potential to treat Alzheimer's disease.  

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