Pfizer dropped out last year, but smaller companies continue to look for treatments for Alzheimer’s disease.

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The Alzheimer’s Association is providing seed money to some start-up companies to launch research into treatments. Getty Images

There’s no question that there’s a demand for new forms of medication or therapy to treat Alzheimer’s disease.

After all, millions of Americans are affected by this degenerative, and ultimately fatal, form of dementia.

The problem is finding forms of therapy that make an impact — no small feat considering how tricky it is for medical science to truly understand what’s going on in the brain.

Pharmaceutical giant Pfizer made waves last year when they announced they’d be moving away from Alzheimer’s research after failing to make progress.

While this news represented a setback for Alzheimer’s research, numerous smaller labs have moved in to fill the gap in the wake of Pfizer’s departure.

“We are seeing a flowering of new ideas,” Keith Fargo, PhD, director of scientific programs and outreach for the Alzheimer’s Association, told Healthline. “It’s a very exciting and interesting time in Alzheimer’s and dementia research.”

Dr. Douglas Scharre, director of the Division of Cognitive Neurology at The Ohio State University Wexner Medical Center, said that dementia is notoriously tricky to understand.

“We’re still struggling with Alzheimer’s to know, besides some of the genetic factors, what the other factors — and there may be many — that will cause this,” he told Healthline. “If we don’t know all the aspects of it, then we don’t have our full arsenal to try to treat it.”

This helps explain some of the failed attempts to develop a drug to treat Alzheimer’s.

In Pfizer’s case, years of research targeted amyloid plaques. These clumps of protein in the brain are naturally occurring, but elevated levels are associated with Alzheimer’s disease.

That research road ended up as a dead-end street for Pfizer.

Fargo noted that Pfizer’s departure says more about the company’s research and development pipeline than it does about the state of Alzheimer’s research.

A publicly traded company such as Pfizer has an obligation to its shareholders to show a return on its investment.

“The first pharmaceutical company that gets to market with a true disease-modifying drug for Alzheimer’s stands to make literally billions of dollars — probably billions of dollars per year,” Fargo said. “If they look at their own pipeline of drugs that they’re developing, and they look at their competitors’ pipelines, they may feel like the chances aren’t great for them to be first to market.”

After high-profile failures in attempts to develop amyloid-busting drugs, some Alzheimer’s research has gone back to the drawing board to look at different ways to treat the disease.

The research has become varied and so have the labs that are conducting it.

“Now, we’re seeing a lot of companies investing more in alternative strategies,” said Fargo.

While much of the research is being done by smaller companies, that doesn’t mean that big pharmaceutical giants are necessarily out of the game.

“Sometimes, big companies do their research in-house,” Fargo explained. “But other times, they allow smaller companies to start that process. And then if one of the smaller companies have something that looks promising, they could be purchased by one of the larger pharmaceutical companies that will then take that football, run with it, and try to get it across the goal line.”

Research into amyloids is still happening.

One notable sign of progress is that doctors are now able to detect amyloid biomarkers in the brain while a patient is still alive, whereas this only used to be possible in deceased patients.

There’s also no shortage of research into non-amyloid avenues, too.

The Alzheimer’s Association’s Part the Cloud program provides seed funding for high-risk, high-reward early stage trials.

Several grants have been given to smaller labs investigating the link between brain inflammation and Alzheimer’s disease. INmune Bio is studying this connection, while Longeveron is investigating the use of adult stem cells to reduce inflammation.

Another grant recipient is a start-up called NeuroTherapia. Researchers there have developed a compound that can reduce inflammation.

Scharre said that his colleagues at The Ohio State University are working on technology that uses low-intensity focused ultrasound to make the brain more accessible.

“You can focus it on a particular part of the brain, maybe where they have the memory circuits that are filling up with these plaques and tangles,” he said. “Our hope is that if we can temporarily open up this blood-brain barrier, we can put in our medications that might help get rid of the toxins.”

Another avenue of future research could revolve around genetic therapies.

“We’ve had some progress with spinal muscular atrophy and a few other conditions where genetic therapies may play a significantly important part,” said Scharre. “And we do know some genes that are involved with Alzheimer’s disease that we could potentially target. So those are, I think, going to be very prominent in the next five years or so.”

Fargo said that high-profile failures such as Pfizer’s contain a silver lining. They’ve opened up new areas of study, along with encouraging smaller labs to conduct their own research.

“You’re starting to see a diversification of drug targets, partially because of the high-profile failures,” he said. “But I would say this is equally, if not more, because the kinds of tools that those researchers have available to them now actually allow them to look at those targets. They’ve become a tractable problem, rather than an intractable problem.”

Pfizer made headlines last year when the pharma giant announced it was moving away from Alzheimer’s research.

But this doesn’t mean that Alzheimer’s research has been abandoned in general.

Smaller labs have moved into the void created by this high-profile departure and they’re making strides in finding new ways to study and understand the disease.

The labs are continuing to look into amyloid plaques but are also studying inflammation and genetic components.