The link between type 2 diabetes and Alzheimer’s disease has led to a pilot study showing that pioglitazone may delay progression of Alzheimer’s disease, perhaps by reducing an inflammatory response to amyloid plaque in the brain, according to a presentation at the 2006 International Conference on Alzheimer’s Disease and Related Disorders.

“We believe that the drug may reduce the body’s inflammatory reaction to one of the toxic components that builds up in Alzheimer’s, called amyloid plaque, ” said Dr. David Geldmacher, an associate professor of neurology at the University of Virginia.

The drug pioglitazone was tested in a placebo-controlled trial involving 25 people with mild to moderate Alzheimer’s disease. The study assessed the safety of the drug and, although the treatment appeared to reduce Alzheimer’s progression, the study was too small for investigators to be sure of the effects on memory and everyday abilities. However, the findings are promising enough, researchers say, to carry out larger studies of pioglitazone.

The presentation was selected by Conference organizers to be highlighted because of a growing sense of the relationship between diabetes and Alzheimer’s disease.
“We don’t know exactly how pioglitazone works in Alzheimer’s, but there are two possibilities,” Geldmacher said. “It could be that the drug reduces the body’s response to the amyloid protein found in Alzheimer’s. Or, it could be that this drug helps brain cells function. The real advantage is that it’s a completely novel approach to treating the disease.”

In the next few years, Geldmacher and his colleagues hope to study the effectiveness of pioglitazone in a group of 200 to 300 Alzheimer’s patients nationwide.

“If it works, this treatment might allow people to better hold on to memory and brain function over a period of time, despite having Alzheimer’s,” Geldmacher said. “It could also complement other treatments and become part of a multi-pronged approach to Alzheimer’s treatment.”

Currently, there are five drugs approved in the USA to treat Alzheimer’s, Geldmacher said, but pioglitazone is unrelated to any of the others.