Viagra may significantly reduce risk of Alzheimer’s, study finds

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An analysis of a large database of insurance records from more than seven million Americans found that Viagra can reduce the risk of Alzheimer’s dementia by as much as 70%.

In the study, published in the journal Natural aging this month, a team of researchers from the Cleveland Clinic in Ohio used computational methodology to identify drugs approved by the U.S. Food and Drug Administration (FDA) that could be used as potential therapies for Alzheimer’s disease.

Scientists searched for drugs that target amyloid plaques and tau tangles, which are believed to be responsible for the brain damage associated with Alzheimer’s disease. Since the interaction between these two molecules contributes more to Alzheimer’s disease than either amyloid or the tau protein itself, researchers have focused more on therapies that attack both.

“Sildenafil, which has been shown to dramatically improve cognition and memory in preclinical models, has been touted as the best drug candidate,” said the study team leader, Feixiong Cheng, PhD, from the Cleveland Clinic Institute of Genomic Medicine.

Through MedlinePlus, the drug is a common prescription drug, currently sold as Viagra to treat erectile dysfunction and as Revatio to improve exercise capacity in adults with pulmonary arterial hypertension (high blood pressure in vessels carrying blood to the lungs causing shortness of breath, dizziness and fatigue).

A systematic review published in April 2020 in the Journal of Alzheimer’s Disease Reports looked at research evaluating sildenafil in relation to Alzheimer’s disease and found that the drug was linked to increased neurogenesis (growth and development of nervous tissue) and decreased inflammation.

This type of advantage makes sense, according to Len Horovitz, MD, internist and pulmonologist at Lenox Hill Hospital in New York, because sildenafil improves blood circulation.

“Most neurologists will tell you that one of the most important things in Alzheimer’s disease is exercise because exercise increases blood flow,” says Dr. Horovitz, who was not involved in the exercise. ‘study. “Anything that increases blood flow will have a beneficial effect on the functioning of the brain. It wouldn’t surprise me if this treatment shows promise, even if it does offer prevention, it’s hard to say.

The results of this study suggest that prevention could indeed be a result. In their analysis of insurance claim data for 7.23 million people, Cheng and colleagues found that sildenafil users were 69% less likely to develop Alzheimer’s disease than non-sildenafil users after six. years of follow-up.

Looking at sildenafil against other drugs explored as potential treatments for Alzheimer’s disease, the study authors found that Viagra / Revatio reduced the risk of getting the disease by 55% compared to losartan, 63% versus metformin, 65% versus diltiazem and 64 percent versus glimepiride.

Dr Cheng pointed out that sildenafil reduces the risk of Alzheimer’s disease in people with coronary artery disease, hypertension and type 2 diabetes (all of which are co-morbidities significantly associated with the risk of dementia) as well as in those with coronary artery disease, hypertension and type 2 diabetes. people without these conditions.

Although the study linked the drug to prevention of Alzheimer’s disease, the authors pointed out that this investigation did not prove that sildenafil actually offers protection or a benefit in this regard.

In separate research examining brain cells from Alzheimer’s disease patients, Cheng and colleagues found that sildenafil increased brain cell growth and decreased tau protein hyperphosphorylation (a process that leads to neurofibrillary tangles. ). These findings have given scientists biological information on how the drug can protect the brain.

Up to 5.8 million Americans are living with Alzheimer’s disease, and the number of people over 65 with the disease doubles every five years, according to the Centers for Disease Control and Prevention (CDC). While the Alzheimer Association lists treatments that can slow the progression of the disease, no cure exists.

“More than ever, Alzheimer’s researchers understand that a variety of approaches will be needed – most likely used in combination – for effective treatment of the disease,” says Claire Sexton, Doctor of Philosophy, the director of scientific programs and popularization of the Alzheimer’s Association. “Scientists are increasingly testing the potential benefits of drugs approved for other diseases for the treatment of dementia. Reusing existing drugs for new uses can speed up the process of research… and review by the US Food and Drug Administration.

Dr Sexton also points out an advantage with reused drugs: their potential side effects are already known.

As the next step in their research, Cheng and his colleagues are planning a randomized clinical trial to test for causation and confirm the clinical benefits of sildenafil for patients with Alzheimer’s disease.

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