ARI SHAPIRO, HOST:
Researchers in Boston are trying an unusual new treatment for Alzheimer's disease.
UNIDENTIFIED PERSON: All right. Ready?
JOE WALSH: Yeah.
UNIDENTIFIED PERSON: I'm going to start here.
J WALSH: Yeah.
UNIDENTIFIED PERSON: One, two, three.
(SOUNDBITE OF INHALING)
UNIDENTIFIED PERSON: Great job.
SHAPIRO: It's a nasal spray designed to reduce inflammation in the brain. NPR's Jon Hamilton reports on the first patient with Alzheimer's to receive it.
JON HAMILTON, BYLINE: His name is Joe Walsh, and he's just inhaled a monoclonal antibody that will change the behavior of immune cells in his brain. Walsh and his wife, Karen, are in an exam room at Brigham and Women's Hospital. A neurologist, Dr. Brahyan Mendez, has arrived to assess Walsh's thinking and memory.
BRAHYAN MENDEZ: Can you tell me your name, please? What's your name?
J WALSH: Joe.
MENDEZ: OK. And who is with you today?
J WALSH: We'll do that.
MENDEZ: What's her name?
J WALSH: Her name. That's her name.
KAREN WALSH: (Laughter).
J WALSH: That's my wife.
HAMILTON: Karen Walsh - the woman he's been married to for 36 years. Back in 2017, she noticed a change in her husband.
K WALSH: He was struggling to find the right words to complete, like, a thought or a sentence.
HAMILTON: They saw a primary care doctor who said that if Walsh turned out to have Alzheimer's, he should enter a research study in hopes of getting one of the latest treatments. Walsh was referred to a neurologist, and in 2019, a PET scan confirmed his diagnosis.
K WALSH: As much as I was in shock, the words were ringing in my head - you know, ask for the research.
HAMILTON: So she began looking for a clinical trial.
K WALSH: We started with blood work and signed all the paperwork, and then COVID hit in March of 2020.
HAMILTON: Hundreds of clinical trials were suspended, and by the time the pandemic subsided, Walsh's Alzheimer's had progressed to the point where he no longer qualified for most studies. Then, in 2024, Karen brought Joe to Dr. Seth Gale, a neurologist at Mass General Brigham.
SETH GALE: And I told them that I would keep my eye out for opportunity for some novel drug to take.
HAMILTON: Before long, Gale received a query from a colleague.
GALE: Does anyone know of a patient who has moderate Alzheimer's disease? And I remembered Karen and Joe.
K WALSH: Dr. Gale called me, and he said, I think I have some research that Joe could be involved in. Would you be interested?
HAMILTON: The research involved a monoclonal antibody being tested on people with multiple sclerosis. MS occurs when the immune system mistakenly attacks the protective covering around nerve fibers, causing inflammation. Dr. Howard Weiner, a professor at Harvard and neurologist at Mass General Brigham, says the treatment was producing good results with MS patients.
HOWARD WEINER: It induces regulatory cells that go to the brain and shut down inflammation.
HAMILTON: So Weiner thought the monoclonal antibody, called foralumab, might work on another condition that damages the nervous system.
WEINER: I've always been interested in Alzheimer's disease. I lost my mother to Alzheimer's disease.
HAMILTON: Most efforts to treat Alzheimer's involve clearing the brain of the disease's hallmarks - sticky amyloid plaques and tangled fibers called tau. But Weiner says Alzheimer's also causes inflammation in the brain, especially as the disease progresses.
WEINER: Once people have Alzheimer's, the inflammation is driving the disease more. So if you give the drug to treat inflammation, the disease won't progress as much and the patients will do better.
HAMILTON: At least that's what Weiner is hoping. The approach worked in mice, but in order to treat Walsh, the researchers had to get special permission from the Food and Drug Administration. Once Walsh started taking foralumab, Weiner says, the inflammation in his brain began to subside.
WEINER: I've never seen anything like this, and we've tried a lot of things. So I think this is something special.
HAMILTON: Especially because the treatment appears to have no serious side effects. The results with Walsh are described in the journal Clinical Nuclear Medicine. Of course, the drug can't restore lost brain cells, and it will take a battery of cognitive tests to see if it has helped Walsh's memory and thinking. Karen Walsh says after six months of treatment, her husband still struggles to find words, but she thinks he's become more engaged in social activities.
K WALSH: A couple of guys come pick him up once a month, you know, and they take him out for lunch. They sent me a text after, saying, wow, Joe is really smiling, really laughing and very involved. So that's where I'm seeing more of the change.
HAMILTON: As for Joe Walsh, he says he's OK with staying on the drug.
J WALSH: It's easy enough to take it, and so I do it, and it feels good.
HAMILTON: A clinical trial of foralumab for Alzheimer's disease is scheduled to begin later this year.
Jon Hamilton, NPR News.
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