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  May 21, 2014
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From the Editor's Pen
Gary Barg • Editor-in-Chief • gary@caregiver.com

Gary Barg
Talking Tau with
Dr. Claude Wischik

Executive Chairman and
Co-founder of
TauRx Therapeutics

Gary Barg: I am finding there is a lot of talk about tau these days. It seems like there is a lot more acceptance of your work than before. Why do you think amyloid theory took such hold for so many years?
Claude Wischik: It has much more to do with the politics of science than the science itself. There is no doubt that there were important genetic findings in the ‘90s which certainly gave new clues to the causes of Alzheimer’s disease. It was found that if you have a mutation in the amyloid gene then this for sure leads to Alzheimer’s disease, but only in extremely rare cases. And it was the time of the molecular biology revolution when people thought, “Fine, the pathology is there in the brain, the gene has been linked to the pathology: game, set and match.” That was just the climate. When it became apparent that you could have lots of amyloid in your brain and not be demented, that really did not register because, by then, there was such a commitment to it. There was such a commitment to it financially and career-wise by people that it just became impossible to back out. That is where I think a lot of companies find themselves at the moment.


Gary Barg: You are going to release some detailed scientific papers reporting your research later this year. Can you explain to the layman what you have learned so far from the ongoing tau trial?

Claude Wischik: What I can say is that the safety profile looks good. There have been no big issues turning up and the drug seems to be well-tolerated. The dropout rates are less than we had anticipated, and we are even getting interesting anecdotes from various principle investigators.

Gary Barg: I understand that you need to be blind to it at this point; in any appropriate clinical trial, you should be. I’m actually interested in the anecdotes that are coming in which are outside the norm of what you have seen for 30 years of doing clinical trials.

Claude Wischik: You’re right – as the trials are double-blinded, all of this could be placebo-effect, of course, but some of the comments from the investigators are encouraging. One investigator said that he has been doing trials for 30 years and particularly the amyloid trials over the last 10 years or 12 years, but there just were no good anecdotes to tell. There is a certain expected trajectory that people follow when they have the disease. Once they are on the downward trajectory, they do not change course. Whereas, with our trial, there are stories suggesting some patients may be changing course, which is exactly what we hope for. We will have to see the final outcomes of the studies before we can say anything definitively, but these unsolicited reports from the investigators are encouraging.

Gary Barg: Could you talk to why a family caregiver of someone living with Alzheimer’s or FTD [frontotemporal dementia] should consider a clinical trial?

Claude Wischik: The logic is really easy. On the one hand, you have got 100 percent certainty that your loved one’s disease is going to progress. And on the other hand, you have a chance that A) the drug works and B) your loved one will be randomized to the active arm. So a zero percent probability of benefit versus some percent probability of benefit, that is what should be the driver. Ninety percent of the patients coming into our AD [Alzheimer’s disease] trial are already on AD drugs. What that is saying to you is they are on these drugs, but they are declining and they want something else. The next thing I would say is: Okay, even if you have the bad luck to be on the placebo arm, you are no worse off. You still have whatever treatment you came with, number one, and number two, if you can stick it out, you will with 100 percent certainty get the active treatment for free at the end of the study. You will also get a phenomenally proper, thorough, no-expense workup of the condition which you probably could not afford to get on your own.

Gary Barg: What is the most important thing you want to leave family caregivers with?

Claude Wischik: The most important thing is to find a good care manager. Find someone to guide you through the labyrinth. Pay money; find out how to get access to support. My father just died with dementia so I know about this. The care manager is precious. And gain access to the support systems that are out there. Until the breakthrough technologies come, that is the lifeline.

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