Alzheimer Disease update

encouraging info below- meanwhile managing your stress level is your way 
to reduce issues with your brain function later.  Keep physically active. 
Use your brain in challenging and novel ways regularly.  I play soduku.  
Take Curcumin supplements-right now this is the only substance we know of 
that dissolves amyloid.

AN2401, a Promising Novel Treatment Against Alzheimer Disease

The positive topline results from Study 201 have led to the initiation of an open-label extension for the subjects previously enrolled in Study 201, which is set to begin later this year.

Dr Chad SwansonChad Swanson, PhD

With the announcement of positive top line data from the phase 2 study of BAN2401, an anti-amyloid beta monoclonal antibody under investigation for the treatment of Alzheimer disease, Eisai and Biogen have begun planning an additional confirmatory open-label extension for subjects previously enrolled in Study 201, which is set to begin later this year. Topline results demonstrated a clinically meaningful difference in disease progression at the 10 mg/kg bi-weekly dose compared to placebo after an 18-month period.

To dive deeper into the results from Study 201 and discuss next steps for the investigational therapy, NeurologyLive spoke with Chad Swanson, PhD, Senior Director, Neurology Business Group, BAN2401 International Project Team Leader and Clinical Lead, BAN2401-G000-201 Study Director. Swanson explains that the data suggests that treatment with BAN2401 not only leads to a clinically meaningful difference on several clinical outcome measures when compared to placebo but that the rate of decline over 18 months is significantly slower in the intervention arm than placebo.

If BAN2401 does become FDA approved, treatment with the therapy could potentially slow the rate of disease progression and clinical decline for patients with early Alzheimer disease, which is tremendously impactful for not only patients but caregivers and families.

NeurologyLive: What are the results from Study 201?

Chad Swanson, PhD: The topline results of Study 201 demonstrated a clinically meaningful 30% difference in disease progression at the 10 mg/kg biweekly dose of BAN2401 compared to placebo at 18 months, which was found on the clinical efficacy measure of Alzheimer’s Disease Composite Score (ADCOMS) which we developed to detect changes in cognition and function on items that are most impacted early in Alzheimer disease.

This dose of 10 mg/kg biweekly of BAN2401 began to show its clinical benefits on ADCOMS as early as 6 months, and that effect was sustained over the entire duration of 18 months of treatment. Results for this dose on other endpoints including Alzheimer’s Disease Assessment Scale-Cog (ADAS-Cog) and Clinical Dementia Rating Scale (CDR) Sum of Boxes (CDR-SB) were also meaningful at 47% and 26% less decline at 18 months versus placebo, respectively.

Biomarker analyses that were conducted, which included change from baseline and amyloid positron emission tomography (PET) standard uptake value ratio (SUVR) (PETSUVR) showed a 70 unit reduction on the Centiloid scale and a conversion rate of 81% for amyloid positive to amyloid negative on amyloid PET visual reads, again at this top dose of 10 mg/kg biweekly.

We’ve seen some results on cerebrospinal fluid (CSF) biomarkers of neurodegeneration, such as neurogranin, phosphor-tau, and neurofilament light chain, all showing trends that are suggestive of BAN2401 having an impact on the underlying pathophysiology of Alzheimer disease. We pooled the top 2 doses of 10 mg/kg biweekly and 10 mg/kg monthly, in this case, and compared them to placebo at 18 months, and just by way of note, the ends for those biomarker results were 16 in the placebo arm and 23 in the pooled BAN2401 group.

Finally, BAN2401 had demonstrated an acceptable safety profile through 18 months of study drug administration, with incidents of amyloid-related imaging abnormalities of the edema type, or otherwise known as ARIA-E, which are the main safety observations in Study-201, were less than 10% across any of the treatment arms and less than 15% in equally positive subjects at the highest dose tested of 10 mg/kg biweekly.

What’s the next step?

CS: We’ve initiated active planning on an additional confirmatory study with authorities and we’re also happy to announce that we are running an open-label extension for the subjects who previously enrolled in Study 201, which will begin later this year.

Data we presented thus far suggests that treatment with BAN2401 not only leads to a clinically meaningful difference on a number of clinical outcome measures at 18 months when compared to placebo at this top dose of 10 mg/kg biweekly but also that the rate of decline over 18 months is significantly slower in the treated group compared to that of placebo. This suggests that perhaps if approved, that treatment with BAN2401 could potentially slow the rate of disease progression and clinical decline for patients with early Alzheimer disease. We believe that this overall slowing in the rate of disease progression would be the most impactful for patients with early Alzheimer disease, as well as caregivers and families.

Eisai has a very rich history of innovation in the Alzheimer disease space. We’re very encouraged by the totality of the Study 201 data, we’ve shown clearance of brain amyloid, we’ve seen trends in CSF biomarkers suggestive of effecting underlying Alzheimer disease pathophysiology, and we’ve seen an impact on the rate of disease progression for key clinical endpoints and clearly we’ve learned a tremendous amount about the potential for BAN2401 in this early Alzheimer disease population over the last few months and we certainly look forward to communicating next steps for the program as soon as our discussions with regulators have concluded.

Alzheimer Disease update

Oops, I did it again….

Last week was a very very bad week for me.  So much so that it feels like it didn’t even happen.  So in my mind Thanksgiving is 2 weeks away – not one week away like it seems stuck in my head. So I will have from 20-30 people and have done zilch so far. But no, I’m not worried. I dealt with that sometime ago when I decided to “embrace the chaos”.

So it was soooo bad I thought I was having a nervous breakdown because I really couldn’t function. Everyone close to me who could see- my hubby and sister- were pretty concerned.  And then I was like “what the f- brain?” and I finally figured it out.

So I take alot of supplements, like alot!  It helps me stay well, I hardly even get a cold and when I do it’s super nothing like vague tiredness and a sneeze or two- so that batch takes up a whole drawer of my nightside table alone with my meds.

I usually never throw a bottle away until it’s replaced – but this time I went to the computer, ordered my branded antidepressant because the generic didn’t work for me and then spaced out…..

So I have no idea how long I was without my antidepressant.  The day I figured it out was the day of my granddaughter’s 2nd birthday party and I was doing my darnest to try to focus on how happy I would be to see her and her little brother.  It was a challenge and then ah hah!  I checked my medication cassette and realized my mistake!  I was so grateful to realize there was an explanation that I immediately felt better and took one of my generics and felt better in an hour – not well but much much better.

So, when my patients sheepishly think I will yell at them because they forgot or stopped their meds- I don’t and won’t. We all make mistakes.  My husband  and sister both say they will ask me next time they see me that “crazy”.  For a week,  I did whatever I needed to and went to bed, I slept hours and hours and could hardly function. It was incredibly painful, but especially frightening.

So, who cares about the turkey.  I have so much to be grateful for.  I’m so grateful for this little pill that helps me live my life and feel good much of the time. What a freakin miracle! I’m so grateful I’m alive in this time when such a little miracle is available to me.

And when patients tell me about hating their medication? Not wanting to be on one?  Well, that’s their choice.  Me, I am no fan of suffering. F- ck suffering people!  This life is hard enough!  No one gives you a purple star for being a hero and suffering!  It’s your own f-in choice and nobody else’s business but the ones you trust. Find the meds that work for you! And if your own prescriber won’t help you, find someone who will.


Oops, I did it again….

Great expectations- not

So I was too optimistic thinking the finishing of the book meant that the book was finished. First I had to have my cover artist reformat it about 10 times, and then there were the internal format issues, convering the document to PDF, these things are not my forte, and it’s been on frustration after another. Each time I think it’s done, it’s not, and each time I have to resubmit everything and then wait 24 hours, how fun? Not.

Truthfully, had to find a couple live humans among the drones and if not for them, I might have shelved the whole shebang again.  30 calls, multiple hours on hold, 2 real human beings with a soul.  Not bad.

So maybe december 1st.  Just remember, if we expect things we’re always disappointed. That’s how life works. But if you go through it expecting nothing, wonderful surprises are there every day.

I’m putting it in writing for myself, my hubby and you all. This is the last book. Never again.

It was much easier years ago when there were live people helping, now it’s all computer software and you need to be a genius or professional at knowing the software.

Boy I’m tired.

maybe soon


Great expectations- not

Reincarnation for dummies

In the Buddhist tradition, each life force is believed to be reincarnated in a form related to their life on earth

Given this, here are my predictions

Donald Trump will return as a mosquito.  Granted he will be the biggest, ugliest, and most TREMENDOUS mosquito you’ve ever seen.Image result for ugliest mosquito

Mitch MicConnell will be a bottom dwelling eel. Image result for most disgusting eel

Paul Ryan will be a spineless slugImage result for slug

Sarah Huckabee Sanders, Kellyanne Conway,  and Sean spicer will be cockroaches

Image result for cockroaches

John McCain will be a Bhutan Glory butterfly, endangered and rare



Image result for bhutan glory butterfly

Reincarnation for dummies

Suicide touches us all

A week ago today Dr GS shot himself in the head.  Two people I am close to knew him very well.  He worked as a psychiatrist.  How would you feel right now if the person who was treating you took their own life?

He had reasons.  His wife was divorcing him and his children weren’t speaking to him. His wife had already moved on with someone new.  She was doing everything she could to get as much of his finances as she could.  He canceled his life insurance 2 days before.  I suspect his initial plan was to make it look like an accident, and I guess that didn’t work out, but it means he clearly decided days before he did it.

Mondays are hard days.  Maybe the idea of facing his patients one more day when he felt he couldn’t pretend anymore was just the tipping point.  Very sad.

It is thought that doctors have the highest suicide rate of any profession, 40 out of 100,00 doctors kill themselves yearly.

A book takes a long time to write, edit, and print.  I’m in my 5th year of writing “Please don’t die”.  I wonder how many more names will be added before it’s finished.

Life is painful, but if we don’t learn to tolerate the pain we also won’t realize the joy of it’s absence. Live today mindfully, and with appreciation for all that you have in this moment.

Suicide touches us all

Letter to the rest of the world from us 60% of Americans

Does anyone else feel we need to do this- publish this somewhere to offset the negative PR of our current POTUS?

Dear World,

We are wanting to connect with you from the majority (57%) of Americans that

  1.  We love our allies and love all your countries, the POTUS doesn’t speak for us
  2.  We are not racist or white supremacists as a country
  3. We care about feelings, ethics, morals, and behavior.
  4. We understand that words matter, and are horrified by our POTUS every day
  5.  We are a country of immigrants and value our ethnic differences and religious differences. We value family. We value children. We value and embrace diversity.
  6. Eventually enough people with character and class will again be running our country. Until then, please don’t abandon us.  Fruitcake does not speak for us.


Sincerely, most of the good people of the United States, who hope to be free of this tyranny and embarassment sometime soon, and understand it will take years to repair the destruction of this POTUS.

Letter to the rest of the world from us 60% of Americans

Wow – Scott Stabile

This is his Instagram link- give yourself the gift of checking him out!

Wow – Scott Stabile

Wonderful share from Dr Pam Wible- enjoy

“(Warning: I have a lifelong problem of “freaking people out” by sharing too much detail. Hang with me . . .)

When I was a little kid, I had this ritual with my dad. I’m pretty sure we were the only two people in the world that ever did this. It’s kinda weird and I’ve actually never told anyone the full version of what we did together cause I didn’t want to freak anyone out.

Man, now I’m crying just remembering this ritual. . .

Dad’s been gone nearly 4 years. Maybe I can’t stop thinking of him because Father’s Day was last Sunday, but whatever the reason, every time he crosses my mind, this is the memory I come back to time and time again. I’m certain it changed the entire destiny of my life.

So here goes. . .

Both my parents are physicians. Mom’s a psychiatrist, Dad’s a pathologist, a medical examiner. They weren’t home much because they (like most docs) were total workaholics!

With no childcare (babysitters kept quitting and that’s another story), Dad would take me to work at the morgue. The morgue was my favorite spot. It was like our secret clubhouse. Nobody ever bothered us there. No interruptions. It’s not like anybody really wants to go to the morgue ya know . . . except me and my dad. So to me, it’s the most peaceful place ever.

Here’s the ritual. . .

Every morning when we entered the morgue, Dad would open up the stainless-steel doors to the big cooler and he’d say, “Good morning! Is anyone home?” Then he’d prop me up and introduce me to everyone one by one (by the toe tags!). He’d literally announce, “Look! It’s Sally!”

And he’d be SO happy to meet her. Kinda like introducing me to a long lost relative.

Okay, let me back up and explain I was one of those really talkative kids that would wear all the adults out because I couldn’t shut up for a minute. I was WAY too much for most people. Too intense. Too needy? I’m still not sure.

But Sally could handle me. So Dad would leave me there to talk to HER. (Plus he got the break from me I’m sure he needed).

“Sally, how are things going for you?” I pause.

No answer.

So I answer for her.

In my eyes, Sally is a brave woman who has led a heroic life. And I make up a fantastically wild and amazing story about her life and all the beautiful things she got to see and do in the world and I’m VERY committed to my version of her life story.

[Granted this is a poor hospital in the inner city of Philadelphia—a city with the highest homicide rate in the USA at the time]

“She was probably a single mom who’s life was cut short by poverty, drugs, and violence,” Dad would try to explain.

But I’m relentless.

I keep telling him MY version of her life story (and I’m VERY persuasive).

Eventually, Dad would see there was no arguing with me, and would go along with my story.

What a great Dad. Right?

So that’s our special ritual.

That was it.

Just me, my dad, and one of his patients.

Every day when we went to the morgue. Different patient. Same kind of story.

Now as an adult and a doctor myself I realize I’ve spent my entire life seeing the heroic potential in all my patients, friends, and even my foster child. Not everyone lives up to their potential. I used to get sad about that. BUT that doesn’t mean I’m ever willing to let go of the beauty and courage—the heroic story I SEE in each person who crosses my path—even if they can’t see it in themselves.

My story of their heroic life—even if unlived—is still true to ME. I’m not willing to give it up.

I think this makes me a better doctor.

I’m exactly where I’m meant to be. I see it all so clearly now.

My dedication to celebrating the lives of doctors we’ve lost to suicide . . . how I refuse to let these beautiful souls just be covered with a tarp and thrown into a body bag without sending them off with a proper eulogy, flowers, and a celebration of their life and contributions to the world. Even if I have to write it myself. Even if I didn’t know them when they were alive. Someone has to write their heroic story. May as well be me. . . I’ve been preparing for this since I was a little girl.

As a child I enjoyed seeing the fantastically wild adventures in the lives of my dad’s patients in the morgue, but now, as an adult, I much prefer to help physicians LIVE out their wildest dreams while they are still breathing which is why I continue to lead “Live Your Dream” physician retreats . . .

So doctors can really be real healers—not just assembly-line factory workers. Everyone deserves to live their dreams.

The bottom line is I believe in your dreams even when you don’t believe in your own dreams.

I believe everyone’s a hero. (Some people just don’t know it yet).

Do you agree? I’d really love to know what you think.

Please leave your comment here.


~ Pamela

Wonderful share from Dr Pam Wible- enjoy

Real life with ADD

This morning I made my coffee and went to add my vanilla coconut milk creamer.  It had already been opened.  I swear, I just bought this monday and drank no coffee yesterday so I know   it’s been “tampered with” or returned to the store and accidently put on the shelf.  Some milk is also gone, besides the seal gone.  How does this relate to ADD? Because you’re never sure if you just forgot…

I drank it anyway. So if I should die or get deathly ill today, please register my final words as these:

“Sometimes you have to live dangerously to get good coffee”

PS my final act of kindness was rescuing a daddy longlegs out of my shower and releasing him safely outside.



Real life with ADD