Symphony Park – February 2015

Symphony Park – February 2015


Cleveland Clinic Lou Ruvo Center for Brain Health is currently engaged in two prevention trials of individuals who are currently cognitively normal, yet considered high risk for Alzheimer’s because of their genetics. Both trials aim to interrupt the progression to Alzheimer’s.

Lou Ruvo Center for Brain Health leaders serve on national steering committees for both of these trials, further establishing the role of the center in national research efforts.

Drugs being tested include a pill (TOMMORROW) and an IV infusion (A4):

Director Jeffrey Cummings, MD, SCD from Lou Ruvo Center for Brain Health serves on the national steering committee for the TOMORROW trial.

The TOMMORROW trial is evaluating whether pioglitazone, a Food and Drug Administration-approved drug that is used to treat type 2 diabetes and that also protects nerve cells, can prevent or delay the onset of Alzheimer’s disease.

In addition to evaluating pioglitazone as a preventive medication, the trial will test whether specific genes are valid tools for predicting the risk in people older than 65 of developing mild cognitive impairment due to Alzheimer’s disease within five years. One of these genotypes is TOMM40, which inspired the study’s name: TOMMORROW.

“If people knew their risk of developing Alzheimer’s disease, it would help them better plan for the future,” says Kate Zhong, MD, Senior Director of Clinical Research and Development at the Lou Ruvo Center for Brain Health. “We are using this trial as an opportunity to educate people about the importance of prevention. There is so much that people, even those with genetic risk factors, can do to decrease their risk of developing Alzheimer’s, such as exercising and following a healthy lifestyle,” says Dr. Zhong.

Associate Director Charles Bernick, MD, MPH from Lou Ruvo Center for Brain Health serves on the national steering committee for A4 Trials.

Long before people develop Alzheimer’s disease symptoms, deposits of a harmful protein known as “amyloid” begin to accumulate in their brain cells. Over time, the amyloid protein forms plaques that impair brain functions, usually beginning with memory. Alzheimer’s disease research has focused on trying to develop drugs that remove amyloid plaques in people who have the disease when the plaques are well established. But this hasn’t worked.

“We are trying to find out if an anti-amyloid drug given early can change the course of the disease,” says Dr. Bernick. “If the drug proves effective, it would be a paradigm shift in the way we think about Alzheimer’s. That’s what makes this study so exciting. People with risk factors will be tested and, if they have amyloid deposits, they’ll be treated before developing symptoms.”

A complete list of clinical trials at Cleveland Clinic Lou Ruvo Center for Brain Health is available online at For more information, please contact or 855.LOU.RUVO.

Photo: Courtesy of Cleveland Clinic Lou Ruvo Center for Brain Health

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