This story covered the announcement of “positive” early results for an experimental Alzheimer’s drug called BAN2401, an antibody that attacks beta-amyloid clumps, and which appeared to trigger a surge in the stock prices of two companies developing the drug. The story did an exemplary job of tempering positive spin from the get-go, with cautions in the headline and lead about the financial interests at stake, past failures of Alzheimer’s treatments, and need for more data. It also alluded to the huge potential market for any drug that could arrest or cure Alzheimer’s.
Business stories about unproven treatments must explain the news driving investors without creating false hopes for patients. That can be a tall order.
Alzheimer’s — which has no cure or treatment to stop its progression — is a particularly good example of an area where business stories can elevate expectations of vulnerable patients and their families, only to see them dashed when fuller data becomes available.
The story frames the discussion in terms of income to the company, but doesn’t address the costs to patients or society. The story said the estimated market for a drug that could alter the course of Alzheimer’s “could be worth more than $10 billion in yearly sales.”
Some discussion of the cost to society of treating Alzheimer’s would have been a good addition. Or, the story could have explored the cost per patient using the potential revenue estimates to give readers a sense of how much a drug like this might cost.
There was no mention of the size of the benefit observed.
A STAT news story on this same trial noted that the study failed to meet its primary endpoint, which means the trial failed. As in many past Alzheimer’s drug trials, the company found positive results only in a sub-group of patients. As we’ve written previously, in larger subsequent studies, the drugs have all failed.
The story said reported side effects included reactions at the sites of the infusion and swelling around blood vessels observed with brain imaging, and that the companies “said they plan to present the results in detail at [an] academic conference.”
The story could have been clearer on how common these side effects are and how serious they were. According to the companies’ news release, infusion-related reactions “were mostly mild to moderate in severity. Incidence of ARIA-E (edema) was not more than 10% in any of the treatment arms, and less than 15% in patients with … the highest dose per the study protocol safety and reporting procedures.”
These are concerning potential harms for which no one knows the long-term consequences.
Cautions were given early and often about the uncertainty of the evidence.
For example, a secondary headline cautioned it’s “too soon to say drug marks real advance,” while the lead mentioned that “a string of failures shadow the efforts” to develop a treatment for Alzheimer’s.
The second paragraph further tempered expectations:
Alzheimer’s has proved an especially tough drug target. Approved therapies only relieve symptoms temporarily, and one experimental treatment after another promising to stymie the neurodegeneration has ultimately failed to work. Some pharmaceutical companies, after costly failures, pulled out.
Also mentioned high in the story was the data were preliminary and based on “a mid-stage study looking for the right dose.”
Further down readers were informed of uncertainties around outcomes measures and analytical methods and the need for independent review.
There was no disease-mongering. The story offered some perspective on the impact of the the disease: “An estimated 5.7 million Americans live with Alzheimer’s, a figure expected to rise as the population ages, the Alzheimer’s Association says.”
In addition to business analysts, the story quoted Lon S. Schneider, an Alzheimer’s researcher at the University of Southern California’s Keck School of Medicine, who “warned against reading too much” into the announced results.
The story mentioned there are 126 therapies in clinical development, according to the Alzheimer’s Drug Discovery Foundation, with beta amyloid being the most common drug target being tested in human trials. It also mentioned approved therapies that “only relieve symptoms temporarily.”
There is also evidence that a healthy lifestyle can be of benefit to people at risk for Alzheimer’s and those with early symptoms.
The story made clear this drug is still in development.
The story explained that this is one of many attempts to find a treatment for Alzheimer’s.
The story didn’t rely on the companies’ news release.
Systematic, Criteria-Driven
Monday at #ADA2021, an infectious disease epidemiologist, a journalist, and a researcher shared perspectives on communication of risk in the era of COVID-19: http://ow.ly/ROfR30rMeE7 @AstleyCM @garyschwitzer @berthahidalgo @ADA_DiabetesPro
Shoutouts to @susan_bewley @drkevinknopf @MichaelBaum11 in this call for more than fawning coverage from press releases for these kinds of stories.
Also, linked history inside goes back 5 years just on Grail apparently trying to become Holy Grail. https://twitter.com/garyschwitzer/status/1408849696416841731
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