Population-level pharmacogenomics for precision drug development in dementia

ABSTRACT

Introduction: There is an alarming lack of therapeutic options for dementia (Alzheimer’s disease, vascular/mixed dementia). Despite the enormous effort made by scientists, industry and society, no medication has been approved for the treatment of dementia in almost two decades. In contrast, the affected population is a great consumer of pharmaceutical resources for the management of age-related and dementia-associated disorders, with a high risk of suffering adverse drug reactions which multiply the cost of the disease and aggravate its clinical course. The implementation of pharmacogenomic procedures may help to accelerate drug development and optimize the use of polypharmacy regimes.

Areas covered: The areas covered include the following: determinants of pharmacological and pharmacogenomic outcomes (pathogenic, mechanistic, metabolic, transporter, pleiotropic genes), drug development, pharmacogenomics of dementia (anti-dementia drugs, treatment of cardio-cerebro-vascular risk factors, psychotropic drugs), pharmacoepigenomics, and novel drug targets.

Expert commentary: Therapeutic strategies in dementia need a profound revision, novel drug targets should be urgently identified, and research programs demand a consequent reorientation. Precision medicine can be of help in this endeavor by introducing pharmacogenomic tools and satellite technologies into drug development and into safer disease management. Large-scale population studies and educational programs are necessary; and the practical application of personalized treatments should be simplified with digital devices.

KEYWORDS:

• Alzheimer’s disease
• anti-dementia drugs
• pharmacogenomics

Acknowledgments

The author would like to thank his collaborators Juan C. Carril, Iñaki López, Pablo González, Adam McKay, and Pablo Cacabelos for technical assistance.

Declaration of interest

The author is President and stockholder of EuroEspes (Biomedical Research Center), EuroEspes Biotechnology, IABRA, and EuroEspes Publishing Co. The author has no other relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript apart from those disclosed. Peer reviewers on this manuscript have no relevant financial or other relationships to disclose.

Additional information

Funding

This article was funded by EuroEspes Biomedical Research Center, Institute of Medical Science and Genomic Medicine, and IABRA (International Agency for Brain Research and Aging).