ABC downplays gloomy context in reporting ‘remarkable’ BACE1 finding for Alzheimer’s

Does the story adequately discuss the costs of the intervention?

Not Satisfactory

While this experimental approach is too preliminary to have a price tag, it seems reasonable to expect some mention of cost given that human trials are in progress. That cost is likely to be high given the large sums companies are investing in development. According to one study, Alzheimer’s prevention trials alone “will necessarily involve the enrollment of thousands of subjects, last for years, and incur enormous costs.”

Does the story adequately quantify the benefits of the treatment/test/product/procedure?

Not Satisfactory

The story says researchers saw “reduced neuron loss and better brain function” in the mice, but there’s no data on the how dramatic these effects were. It leaves a false impression that all subjects experienced significant benefits. In fact behavioral changes were small, with about a 10-percent change in fear conditioning for the only statistically significant result.

Does the story adequately explain/quantify the harms of the intervention?

Not Satisfactory

The story does not explain that mice without BACE1 have a number of other signs of brain deterioration, show signs of hyperactivity and are prone to long-term depression. The story notes that BACE1 inhibitors are being tested in humans but skips over the fact that at least two clinical trials in humans using BACE1 inhibitors were stopped due to liver toxicity, and that other studies were stopped early due to unspecified, unacceptable side effects.

Does the story seem to grasp the quality of the evidence?

Not Satisfactory

On the plus side, the story describes how the research was performed and notes that “researchers urge caution with the results as many Alzheimer’s discoveries seem to hold true in mice, then fail in people.” It also quotes a researcher who said that it’s unlikely BACE1 inhibitors would totally halt enzyme production in humans even though the gene that produces the enzyme was deleted in mice.

Those are important points that contradict the overall excitement embedded in the rest of the story, but they don’t arrive until the fifth paragraph.

Near the top of the story we are told: “The deletion of just a single enzyme saw the near total reversal of the deposition of amyloid plaques found in brains of those with Alzheimer’s, improving cognitive functions in the mouse subjects.”

The story did not explain that depleting a marker of Alzheimer’s—the amyloid plaques — is not the same as reversing the disease. The story also leaves out the small size of behavioral benefits observed in the study, which could have been used to explain how a single molecular “fix” may not lead to a benefit.  Supporting that concern is Merck’s recent statement that it was halting its BACE 1 trial because of a lack of benefit. That statement wasn’t mentioned in the story.

Does the story use independent sources and identify conflicts of interest?

Not Satisfactory

The story has only one source: Riqiang Yan, PhD, who was one of the study’s authors. There are no conflicts identified in the story, and none identified in the study.

Does the story compare the new approach with existing alternatives?

Not Satisfactory

The story does not explicitly state there is no cure for Alzheimer’s, and it doesn’t discuss current drug treatments for Alzheimer’s symptoms or other approaches being studied as treatments for Alzheimer’s.

Does the story establish the availability of the treatment/test/product/procedure?

Not Satisfactory

The story explains that the study was done in mice and notes that there are BACE1 inhibitors being tested in humans. It also mentions that researchers “are currently in phase II and, in some cases, phase III clinical trials for the various compounds,” although with no description of what that means in terms of the timeline for drug development.

We would have liked more information on how long it will take for results of these studies to become available, and a caution that an actual treatment is years off at best.

Does the story establish the true novelty of the approach?

Not Satisfactory

The story makes the approach sound more novel than it really is. What the study showed—for the first time—was that amyloid deposits could be reversed in mice that were bred to slowly stop producing the BACE1 enzyme. Research on BACE1 inhibitors has been going on for years.