Products
Oligomannate was approved in China in 2019 in the form of capsules (Shanghai Green Valley Pharmaceuticals). The group led by Prof. Geng Meiyu at the Shanghai Institute of Materia Medica spent more than 20 years on the research. This is the first new oral Alzheimer’s drug since 2003, and another Phase III clinical trial will be conducted in 2020 to obtain approval in additional markets. The drug is not currently registered in many countries.
Structure and properties
Oligomannate (GV-971) is a mixture of acidic and linear oligosaccharides. It is a carbohydrate composed of modified mannose units. They are dimers (2) to decamers (10) with molecular mass up to 1000 Da. Oligomannate is derived from substances found in brown algae (seaweed). In the drug, it is present in the form of the sodium salt as oligomannate sodium.
Effects
In the randomized, double-blind, placebo-controlled phase III clinical trial involving more than 800 patients, the drug improved cognitive function in mild to moderate symptomatology. Some of the initial effects were detectable after one month and were sustained over the course of therapy. However, there are currently insufficient data for an independent evaluation. A comparison with existing drugs such as cholinesterase inhibitors is also pending (as of November 2019). Oligomannate normalizes the disturbed balance of intestinal flora (the microbiome), inhibits peripheral and central inflammation, and reduces beta-amyloid deposition and tau hyperphosphorylation. According to Wang X. et al (2019), increased formation of the amino acids alanine and isoleucine by the altered gut microbiome leads to increased differentiation and proliferation of T-helper cells and invasion of these immune cells into the brain. This leads to an inflammatory response (neuroinflammation) and contributes to the development of Alzheimer’s disease. If this mechanism is true, the question arises whether the same effect could be achieved with conventional prebiotics or probiotics.
Indications
For improvement of cognitive function in mild to moderate Alzheimer’s disease.
Dosage
According to the SmPC. The drug is taken perorally in the form of capsules.
Contraindications
For complete precautions, see the drug label.
Adverse effects
In the study conducted, oligomannate was characterized by good tolerability. However, complete data are not currently available.
