A private clinic in California, USA, appears to be getting dramatic reductions in dementia symptoms by injecting an arthritis drug called etanercept into the neck of Alzheimer’s patients.

Using the drug as an “off-label” treatment (that is the drug is approved by the US Food and Drug Administration, but not for this particular use), the doctors at the Institute for Neurological Research, a private medical group based at the University of California, Los Angeles (UCLA), believe they are restoring communication links in the brain.

Etanercept is normally used to treat arthritis, where it blocks the action of tumour necrosis factor-alpha (TNF), a chemical that causes painful and swollen joints.

However, in the case of Alzheimer’s, TNF is also thought to block the communication between brain cells, so using etanercept restores that function, so the researchers suggest.

The Institute for Neurological Research has posted videos and information on its website that describes Alzheimer’s patients dramatically improving (within minutes in some cases) after receiving the drug. The drug is injected into the spine, at the neck, and then the patient is tilted up to encourage bloodflow to take the drug into the brain.

Many experts say the results are worth investigating further with controlled clinical trials.

The private clinic is currently treating about 50 Alzheimer’s patients using what it describes as the Tobinick Method for the treatment of Alzheimer’s disease. Edward Tobinick is the professor who pioneered the research.

Tobinick said he and his team have observed improvements in patients’ thinking and reckoning skills, as well as memory and verbal skills. They have also noticed improvement in mood and in the “gait” of patients where that has been a symptom. However, the improvements are not so great that the patients can be described as returning to normal, he cautioned.

Doctors at the clinic said they are getting 90 per cent response rates from the drug, usually within minutes.

Some of the patients have been on the treatment for three years, but the typical patient improves week by week, as they receive each dose, and the improvements level out after about three months of being on the medication.

One of the videos shows how the treatment affected 82-year old Marvin Miller. Miller can be seen muttering incoherently in response to questions from a nurse. He can’t name objects like a pencil or a bracelet.

Miller is then given his first etanercept injection, and according to the video, five minutes later he recognizes and embraces his wife when she comes up to him. Mrs Miller said he had not done this for years, because until that moment he did not know who she was. She appears visibly shocked by her husband’s improvement.

In another session on the same video Mrs Miller describes her husband’s improvements, four weeks after starting the treatment. He makes sense 90 per cent of the time now, and before the treatment he didn’t make any sense at all, she said.

Dr Susanne Sorensen, head of research at the UK’s Alzheimer’s Society, said in a prepared statement that effective treatments for Alzheimer’s were urgently needed. The disease affects 400,000 people in the UK alone, and there are millions of carers looking after people with Alzheimer’s.

The numbers of people affected by the disease are rising dramatically, and:

“Investment in dementia research is an essential part of confronting this devastating condition,” said Sorensen.

Regarding the apparent success of the Tobinick Method, Sorensen commented that:

“On the surface these results are exciting,” but she said “there are large gaps in the research, which only involved a small pilot group and we cannot draw any conclusions until a controlled trial is carried out”.

She said the Society has concerns about the cost and practical problems involved with a treatment where the patient has to be given the drug by injection into the spine, a procedure that requires specialist staff and facilities.

Sorensen concludes on a cautiously optimistic note and calls for more investment in research:

“It is very encouraging to see alternative ways to treat Alzheimer’s disease being explored. We need to see much wider investment in dementia research in the UK.”

Dr Clive Holmes, a professor at Southampton University, said on BBC Radio 4 this morning that he was keen to do the research, there was enough evidence from what he had seen on the video footage to make it worth doing a small clinical trial, but there was no funding as yet.

Click here to see videos of treatment results (Institute for Neurological Research website).

Sources: BBC News, Alzheimer’s Society (UK), Institute for Neurological Research.

Written by: Catharine Paddock, PhD