With the failure rate for dementia drugs currently standing at over 99 per cent – at a current cost of over US$40bn – UK start-up Prema Cognition believes it can help ease the burden for patients, their families and financiers.
In partnership with the University of Cambridge’s Memory Lab London-based Prema has developed ground-breaking technology which it says has the ability to ‘lead the field in early dementia diagnosis’.
Investor faith in Prema is demonstrated in its latest funding round which netted £550k, bringing total funding to date to almost £2m.
The principal backer in the latest over-subscribed round was UK-based seed capital investor SFC Capital, with money also coming from strategic health tech and pharma angels.
Prima’s USP is its Premaz test, which lasts around 15 minutes and includes 45 short and long-term memory tests.
Patients are shown objects on a device screen and then asked to recall them and their location with the ability to recall events rated in memory sub-type categories including; short-term, long-term, episodic and recognition.
The results are then factored to demonstrate the potential onset of ‘an early loss of memory resolution that may precede actual memory loss by five to 10 years’, says Dr Julia Cooney, founder and CEO of Prema Cognition.
Tests start in middle age
Prema is looking to initiate the test from middle age as the changes identified in the fourth and fifth decade of life have the possibility of progressing on to dementia, years later.
Its longitudinal studies, in partnership with Cambridge over the last five years, have shown that the people flagged as being at risk, developed dementia.
The tests show correlations between the areas of the brain which light-up during the tests, that are specific to those areas which are affected in the earliest stage of dementia, such as hippocampus and the angular gyrus.
Dr Cooney elaborated on the pressing need for its technology: “For cardiovascular disease, you get your cardiovascular risk score. For diabetes, you find out you’re pre-diabetic before you get it. For cancer, you’re doing a screening test.
“But there’s nothing out there for dementia. You just find out when you’ve already got it. And that’s something that we’re really trying to work with GPs to change and to get a national screening initiative for dementia.
“And we’d love to see this becoming a lot more mainstream to just do a routine test. If you have a family history, if you have a genetic risk, do a test like ours and find out before you actually get those symptoms.”
Pharma prize
There are some 50 million dementia sufferers on the planet, and this is expected to rise to 150m by 2050, so the prize for a pharmaceutical company able to slow the decline in dementia is a significant one.
Dr Cooney said: “There’s a massive race at the moment to get the best sort of sensitive early detection tool for dementia and because there’s a bit of a race in the dementia drug space we’re seeing for the first time ever, disease-modifying therapies for dementia are starting to hit the market.
“And, there are over 100 drugs in the pipeline across different pharma companies that target dementia.
“So, obviously with that, all these pharma companies are looking for a test that can pick up these really early changes for their research studies, and they’re looking to acquire companies in this space in the coming years.”
Prema Cognition is actively seeking partners for its technology and has, to date, secured deals with some 30 clinics in the UK and the US.
In the US it is working with a network of care homes and when its catalogue of data approaches five figures – it is currently at 3,000 tests – Prema believes its real-world evidence base will allow it to demonstrate to large pharma the confidence it has in its kit.
Early diagnosis
Dr Cooney, who is also founder and CEO of longevity, healthtech firm Zest, said: “There are two things that the pharmaceutical companies are interested in from tests like ours.
“One, that we’re able to pick up subtle changes that other tests can’t. So there’s a lot of drugs that have failed in clinical trials, not necessarily because they’re not effective, but because the tests out there aren’t sensitive enough to pick up small but meaningful benefits that they might be having.
“And, they might be giving you an extra three years where you remember your loved ones, and it’s just not being picked up because it’s such a small, incremental difference, but actually it is impactful for those patients. So having a more sensitive test helps to pick those benefits up better.
“And then, at the other end, for finding the right patients earlier on. Of all of these drugs that are in the pipeline, every single one of them targets the earliest stage of the disease.
“There’s very little you can do once the brain’s already atrophied and shrunk because you can’t regenerate brain tissue, as we know.
“So you need to get in really early if you want to have any benefit and at those stages, most tests aren’t picking anything up.
“So being able to identify those patients early and say, ‘Okay, this person is going to get dementia in 10 years. If we intervene now, maybe they never will’, rather than picking it up when someone already has it and irreversible damage has already occurred.
“So it’s those two ends of the spectrum, one being identifying the benefit a drug’s already having, the other being picking up the patient before any damage has really occurred.”