One Day, Alzheimer’s Will Give Up Its Secrets and Its Harms

It was yet another entry in a familiar medical-news narrative: A big breakthrough in the treatment of Alzheimer’s disease gets called into question by subsequent reporting. Only this time the off notes hit while the fanfare was still sounding.

On July 25, researchers presented findings at the Alzheimer’s Association International Conference in Chicago showing an investigational amyloid-busting drug had significantly slowed cognitive decline in patients hit by that dread disease.

The numbers were there. The study had enrolled more than 850 patients with early-stage Alzheimer’s. The key discovery came when participants were evaluated for functional memory and cognition 18 months following the start of the drug regimen. Patients who took the drug bettered the placebo control group by 30 percent. (The results correlated with neuroimaging findings. The team used PET to track the plaques.)

The consumer press did its thing. “New Drug Could Slow Down Progression of Alzheimer’s,” NBC News reported. “Experimental Alzheimer’s Drug Stirs Hope After Early Trials,” added CNN. And so on.

As if on cue, the doubters weighed in the very next day. Given the financial stakes for the publicly traded biotech companies behind the drug, it probably shouldn’t have surprised this Alzheimer’s-research watcher that the quickest and strongest skepticism came from the investment world.

“These results are a mess,” Baird biotech analyst Brian Skorney wrote in comments picked up by a bunch of business outlets. “Not so much that they indicate an outright failure of the hypothesis, but they don’t really say anything informative at all.” The hypothesis to which he refers is the one that blames Alzheimer’s awful calling card, fading cognitive function, on the accumulation of sticky amyloid plaques in the brain. It’s compelling but contested. Tau, anyone?

“Further analysis is required,” added Asthika Goonewardene of Bloomberg Intelligence, “but in the interim, it’s a letdown to recent investor enthusiasm.”

A chorus of dismayed money minds soon chimed in with similar sentiments.

In case you’d like to look up the details, the drug is called BAN2401. Its developers are Biogen in the U.S. and its partner Eisai in Japan. Either way, the disappointment may register as mostly financial to some, but it hits much closer to home for lots of others.

Stats from the Alzheimer’s Association tell that story quite concisely. Nearly 6 million Americans are living with the disease. The headcount is expected to more than double by 2050. And 16.1 million Americans are now caring for loved ones with Alzheimer’s or other dementias.

Across disease states, clinical studies and coverage thereof will come and go. Eventually, a research team’s try for a remedy will yield an effective treatment.

In the case of Alzheimer’s, another drug company just announced the design of a new trial to test the amyloid hypothesis “in the most definitive way possible.” May the wind be at that company’s back. And, yes, a payday in its future.