This STAT story is a contextual view of not only the status of doomed scientific efforts so far to delay or halt Alzheimer’s dementia at its biological sources, but also of Big Pharma’s persistence at chasing an anti-amyloid cure.
The reporting makes the case that in the opinion of credible researchers, the reason for failures to date is that Lilly’s drug and others didn’t get to the amyloid when and where it needed to, not that amyloid isn’t the culprit. Although the article could have made the point sooner, it does state clearly that there is still no scientific consensus that amyloid plaque even IS the right target. The story would have been greatly strengthened by giving some quantitative data about the various studies cited, as well as the inclusion of an independent expert.
Given the devastating magnitude of Alzheimer’s disease, reports like the one in STAT are intensely searched for and read by not only those with personal knowledge of the disease, but by the worried well.
It’s too early to discuss how much one of these experimental drugs might cost. But the article could have reported something about the estimated costs of currently caring for these patients. It’s also worth noting that if a drug is ever approved, it will cost Medicare a bundle.
In the story’s descriptions of “promising” drugs from Biogen, Merck and Lilly, there is essentially zero quantification data. There needed to be some, even in a wrap-up or trend article such as this.
The story did not cover harms. A problem with these drugs is that they can cause amyloid-related imaging abnormalities (ARIAs), which are findings on brain scans that indicate swelling and small hemorrhages in portions of the brain. These were the most frequent adverse events in the Biogen study and occurred in a lot of people, especially at the higher doses.
Overall, the story did a good job explaining why several major pharmaceutical firms think there is still hope for an anti-amyloid strategy for Alzheimer’s disease.
As noted in the summary, it might have been useful for the article to have stated earlier–and perhaps more forcefully–that despite the confidence drug developers appear to have in the amyloid hypothesis, the scientific jury is still out. And a discussion of competing hypotheses would have been useful to add, too.
No mongering here.
The story had no independent sources. It also didn’t disclose the conflict of interest of Dr. Paul Aisen, who has received money from multiple drug companies, including the ones discussed in this piece.
The story adequately compares alternatives and discusses the overall lack of any effective medication for Alzheimer’s disease.
As noted above, however, a discussion of competing hypotheses about the origins of the disease, along with related potential treatment strategies, would have been useful to include.
The article makes pretty darn clear that there will be a) no final answers to the amyloid hypothesis debate any time soon; and b) the advent of a successful anti-amyloid drug that helps those with Alzheimer’s is not close at hand.
As noted earlier, this was not a “breaking news” story, but a round up of sorts of what’s happened since the Lilly drug trial for solanezumab reported negative results. But there is news-like information here about the optimism of the companies still working the amyloid hypothesis. Whether a high level of optimism is warranted or not is a good question, but the article could at least inform a healthy discussion.
There appears to be original reporting and perhaps use of one (at least) news release.