Note to our followers: Our nearly 13-year run of daily publication of new content on HealthNewsReview.org comes to a close at the end of 2018. Publisher Gary Schwitzer and other contributors may post new articles periodically. But all of the 6,000+ articles we have published contain lessons to help you improve your critical thinking about health care interventions. And those will be still be alive on the site for a couple of years.
Read Original Story

USA Today provides rosy speculation about an Alzheimer’s vaccine not yet tested in humans

Rating

3 Star

Categories

Researcher: Alzheimer's vaccine could cut dementia in half, human trials may be next

Our Review Summary

This story reports on a study done in laboratory mice that showed a vaccine decreased the build-up of two proteins, amyloid and tau, that are associated with Alzheimer’s.

The story mentions this was a mouse study and acknowledges it isn’t the only potential avenue under study to arrest those harmful substances.

However, it gives an overly optimistic spin, using the word “promising” and playing up a speculative comment in a UT Southwestern Medical Center news release that dementia cases “could drop by half” if there’s a vaccine that delays the onset of Alzheimer’s by five years.

The story also doesn’t caution that success in animals often doesn’t translate to benefits in humans, and that other treatments targeting these proteins have not panned out. Also missing: discussions of costs and potential harms and comments from independent sources.

 

Why This Matters

As the U.S. population ages, dementia is becoming more common. Millions of families are coping with a person who has a diagnosis of Alzheimer’s.

Available treatments do not prevent or cure Alzheimer’s and at best slow down the progression of symptoms for short periods. Considerable effort has focused on new treatments that seek to break down or prevent the deposition of abnormal proteins that appear to increase as memory loss progresses.

So far these new treatments have not been shown to help. Initially they were tried in individuals with advanced disease but now are being used in patients with mild symptoms as a way to prevent progression. Even here, trials have not shown positive results that are clinically meaningful.

A vaccine to “prevent” Alzheimer’s is appealing in that it works even earlier in the process, maybe even before symptoms appear. However, it isn’t clear that a vaccine will actually improve clinical outcomes.

The fact that this small study in mice led to several optimistic headlines — not just USA Today’s — reflects how desperate we are for progress. Regardless, news stories should not make a remedy sound closer and more certain than it is.

Criteria

Does the story adequately discuss the costs of the intervention?

Not Satisfactory

There’s no discussion of costs.

It might be difficult to estimate the cost of a vaccine that hasn’t yet been tested in humans. However, the story could have pointed out that at least some researchers have begun to consider the financial impact of treatments that are in development to slow or delay Alzheimer’s.

For example, British study released in March estimated that a hypothetical vaccine given to everyone over 50 that delayed the onset of Alzheimer’s by five years would yield a savings of about $9,000 in health, social care, and unpaid care costs over a person’s life. It estimated that the justified cost of such a vaccine, if it had to be given every two years, would be $1,175 per dose. However, those figures would drop to a lifetime savings of $2,200 and a justified cost of $293 per dose if the vaccine delayed onset of disease by just one year.

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

Not Satisfactory

The story gives no data to describe the differences in the buildup of amyloid in the brains of mice given the vaccine versus those not given it.

A news release stated: “The latest study – consisting of four cohorts of between 15 and 24 mice each – shows the vaccine prompted a 40 percent reduction in beta-amyloid and up to a 50 percent reduction in tau, with no adverse immune response.”

Also, the story doesn’t explain whether there’s any data behind these speculative comments about potential human benefits from a researcher:

“If the onset of the disease could be delayed by even five years, that would be enormous for the patients and their families. … The number of dementia cases could drop by half.”

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

Satisfactory

The story states that the vaccine is “safe in mice” and alludes to the fact that it hasn’t been proven safe in humans. It also mentions “harmful side effects, such as brain inflammation” with a previous Alzheimer’s vaccine attempt.

For that, we’ll give the story credit. But we think it could have better served readers by explicitly cautioning that safety in mice doesn’t translate to safety in humans.

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

Not Satisfactory

This is a significant weakness.

The story did report that the study was in mice, but didn’t given much information beyond that about how the study was conducted. The vaccine was given to mice at risk for developing an amyloid deposit, while a similar control group didn’t get the vaccine. At 20 months, the amounts of amyloid buildup in the brains of the two groups were compared.

It does not point out that many vaccines and drug therapies have been successful in mice and later were proven unsuccessful in people.

The story also misses a key point: treatments that seek to limit build-up of harmful protein — which the story refers to as “promising” — have thus far not shown much benefit in humans. The story should have cautioned that it’s unclear a vaccine can actually prevent dementia, even if it safely limits protein growth.

Does the story commit disease-mongering?

Satisfactory

No disease-mongering here.

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

Not Satisfactory

The story has no independent sources. The authors asserted no conflicts in the published paper.

Does the story compare the new approach with existing alternatives?

Satisfactory

The story says the vaccine is among “several promising treatments” aimed at reducing the buildup of proteins associated with Alzheimer’s. It could have also mentioned that another Alzheimer’s vaccine is undergoing clinical trials.

It could have also mentioned current available medicines that have a very modest, short-term effect. Drugs called cholinesterase inhibitors have been approved by the FDA to lessen symptoms from Alzheimer’s, but none is curative.

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

Satisfactory

The story makes clear that the vaccine is not available and has not even begun clinical research in human patients. However, it would have been appropriate to give a sense of the time frame. Even if trials started in humans and the vaccine was shown to be safe and effective, it would be years before this became widely available.

Does the story establish the true novelty of the approach?

Satisfactory

It’s clear that a vaccine would be a new approach to Alzheimer’s.

Does the story appear to rely solely or largely on a news release?

Satisfactory

This story barely goes beyond the contents of a UT Southwestern news release, which contains more guarded and accurate language than the story.

Total Score: 6 of 10 Satisfactory

Comments

We Welcome Comments. But please note: We will delete comments left by anyone who doesn’t leave an actual first and last name and an actual email address.

We will delete comments that include personal attacks, unfounded allegations, unverified facts, product pitches, or profanity. We will also end any thread of repetitive comments. Comments should primarily discuss the quality (or lack thereof) in journalism or other media messages about health and medicine. This is not intended to be a forum for definitive discussions about medicine or science. Nor is it a forum to share your personal story about a disease or treatment -- your comment must relate to media messages about health care. If your comment doesn't adhere to these policies, we won't post it. Questions? Please see more on our comments policy.