“Our findings demonstrate that we should recruit more diverse patients to test Alzheimer’s drugs,” says Dr. Feixiong Cheng, a lab director at the Cleveland Clinic Genomic Medicine Institute. Photo by Linda Bartlett/Wikimedia Commons
Nov. 4 (UPI) — Telmisartan, a drug prescribed for people with high blood pressure, may lower the risk of Alzheimer’s disease — specifically in Black patients over age 60.
However, insurance data from millions of adults over age 60 did not show the same potential effect for the medication in White patients.
That’s according to a Cleveland Clinic-led study published Friday in Alzheimer’s & Dementia: The Journal of the Alzheimer’s Association.
“Our findings demonstrate that we should recruit more diverse patients to test Alzheimer’s drugs,” Feixiong Cheng, the study’s corresponding author and a lab director at the Cleveland Clinic Genomic Medicine Institute, told UPI in an email.
For example, Cheng said, “we found that Pioglitazone … is associated with reduced risk of Alzheimer’s disease, as well.”
However, he said, Pioglitazone failed in a large Phase 3 trial that only tested the medication in Alzheimer’s patients who were White.
Pioglitazone, which is sold under the brand name Actos, among others, is used to treat Type 2 diabetes.
Future clinical trials should prioritize including patients from minority populations to find or reinforce associations, Cheng said.
“Considering race-specific drug responses holds potential for drastically improving patient care,” Cheng said in a news release. “Identifying these candidate drugs can also reveal more information about [Alzheimer’s] disease itself through referencing the medicine’s targets.”
Nationwide, 6 million-plus people have Alzheimer’s disease, which is the most common form of dementia, the release noted.
And Black adults over age 60 are 1 1/2 to two times as likely to develop Alzheimer’s than White patients.
Cheng said that African Americans have a much higher incidence of Alzheimer’s disease because they tend to have more risk factors for the disease, such as high blood pressure, diabetes and chronic kidney disease.
Finding effective ways to control such risk factors may reduce the risk of Alzheimer’s disease, he said.
For its ongoing work, Cheng’s team is using artificial intelligence and data from the Cleveland Clinic’s electronic medical record systems “to identify novel targets and repurposeable medicines” for Alzheimer’s treatment, the release said.
For this study, the scientists examined the data of 5 million-plus patients from the Alzheimer’s Disease Sequencing Project, a nationwide network that is trying to identify genetic underpinnings and find effective therapies for Alzheimer’s disease.
Telmisartan is one of a group of drugs that treat hypertension by blocking angiotensin II, a hormone that causes blood vessels to constrict, the release said. It is sold under the brand name Micardis, among others, and also is used to treat heart failure and diabetic kidney disease.
Lisinopril, a blood-pressure medication that works differently, “did not show the same potential benefits as telmisartan, indicating angiotensin II blockers might be helpful in preventing or treating Alzheimer’s in Black patients,” the release said.
Cheng said that lisinopril was used for comparative purposes, “to reduce confounding factors” in the study because it, too, is used to treat patients with hypertension.
Clinical trials will be the best way to further test telmisartan in Alzheimer’s patients who are African American, he said. “If we can receive more funding support, we would be happy to conduct a phase II trial in the near future.”
This study was funded by the National Institute on Aging, a part of the National Institutes of Health, and the Translational Therapeutics Core of the Cleveland Alzheimer’s Disease Research Center.