Beyond excellent clinical care of patients suffering from degenerative brain diseases, part of the mission of the Cleveland Clinic Lou Ruvo Center for Brain Health is to innovate to advance healthcare. One goal is to repurpose drugs already approved or developed for other conditions toward the treatment of neurodegenerative disease. Testing of repurposed agents is important because the side effect profile and pharmacokinetics are well understood, allowing effective agents to be brought to the market more rapidly than new agents.
Currently, we have identified three such drugs and are testing their efficacy in treating neurodegenerative disorders in clinical trials at the Lou Ruvo Center for Brain Health.
- Rasagaline inhibits an enzyme called monoamine oxidase and is approved for the treatment of Parkinson’s disease. Research at LRBCH has suggested that Rasagaline might be useful to treat Alzheimer’s disease (AD). Through a grant from the Alzheimer’s Drug Discovery Foundation, a clinical trial is underway to investigate the effect of Rasagaline on the progression of AD symptoms.
- Bexerotene is an anti-cancer agent approved by the U.S. Food and Drug Administration (FDA) (in late 1999) and the European Medicines Agency (EMA) (early 2001) for use as a treatment for certain types of lymphoma. Research at the Lou Ruvo Center for Brain Health has shown that Bexerotene might be a potent treatment for AD and could even alter the extent of pathology in the brains of AD patients, as detected on brain scans. Further studies are being planned.
- Lenalidomide (Revlimid®) was first approved in 2006 for use in patients with multiple myeloma. In February 2017, Lenalidomide monotherapy was approved in the U.S. for maintenance treatment after autologous stem cell transplantation in patients with newly diagnosed multiple myeloma (Syed, 2017). Lenalidomide inhibits TNF-α production, stimulates T cells, and has immunomodulatory, anti-inflammatory, and anti-neoplastic effects. It also reduces levels of vascular endothelial growth factor (VEGF) and basic fibroblast growth factor (bFGF) and inhibits angiogenesis (NCI Thesaurus). It is a thalidomide analogue with improved potency and reduced toxicity compared to thalidomide. Two clinical trials are being launched to investigate the effects of Lenalidomide in the treatment of mild cognitive impairment as a prodrome of AD. These trials will be launched in early 2020.
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