Treating Alzheimer’s disease with drugs is common during the later stages of the disease as drug treatments can improve mood and reduce the symptoms of the disease. Research into these drugs is essential in ensuring their safety and efficiency. BRACE has funded early, pioneering research into the effectiveness of using drugs called acetylcholinesterase inhibitors to treat Alzheimer’s disease. This research has influenced which drugs have been clinically approved.

Acetylcholinesterase is an enzyme that causes the breakdown of a chemical in the brain called acetylcholine. It is thought that patients with Alzheimer’s disease have lower levels of acetylcholine, which affects communication between nerve cells in the brain. Acetylcholinesterase inhibitors stop acetylcholine from being broken down, and therefore increase acetylcholine levels. The effect is an improvement in communication between the nerve cells, which reduces some of the symptoms of Alzheimer’s disease such as cognition and motivation.

The BRACE Centre, which opened in 1994, tested several acetylcholinesterase inhibitors in Phase III trials. These trials are the final stage of testing, and drugs that pass this phase can then be licensed. This centre was one of only two in the country which were testing drugs for Alzheimer’s disease. BRACE was instrumental in the licencing of one of these acetylcholine inhibitors, a drug called Galantamine. Galantamine was discovered in the 1950s and is produced from snowdrops. In a 12-month study, Professor Wilcock and his team at the BRACE Centre showed that Galantamine was an effective treatment for improving cognition. This led to many important scientific publications, advancing our knowledge of this area and ultimately leading to galantamine becoming licenced for use in Alzheimer’s disease treatment. Galantamine is recommended in the treatment of mild to moderate Alzheimer’s disease in the NICE (National Institute for Clinical Excellence) guidelines, which are evidence-based, best practice guidelines for doctors.

These drugs are still relatively new, and more research is needed to understand how they can be utilised most effectively. However, this BRACE-funded study highlights the importance of research in drug treatments. Through this research, BRACE funding has influenced which drugs are prescribed for Alzheimer’s disease, and made a significant impact on the lives of those affected.

By Rachel Milligan, University of Bristol

This is from a series of articles based on research by Travis Bacon into BRACE's impact 1987-2017. Travis spent 12 weeks with BRACE late in 2017, during which time he researched what BRACE funding had achieved over thirty years and we are very grateful for his work.