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Amyloid pathway doubts after latest Alzheimer’s failure

Published on 25/01/18 at 10:02am

There has been another drug failure in a large Phase 3 that once again crushes a hope for a possible treatment, as well as raising serious doubts about the pursuit of removing amyloid plaques from the brain.

The build-up of amyloid protein in the brain of those suffering from Alzheimer’s disease is one of two key targets from most potential treatments, alongside tau tangles. In early stages of Eli Lilly’s trials into solanezumab, it looked like there might be some confirmation of hypothesis – with modest benefits being seen in small scale trials looking at slowing decline of cognitive function.

However, in a 2,129 patient-strong study, the primary endpoint of improvement on measurement with the Alzheimer’s Disease Assessment Scale-cognitive subscale was unable to show any clinical significance over placebo.

The report delves into the detail of the 2016 announcement by Eli Lilly that it would no longer look at developing the drug. The trial keenly focused on those with mild dementia due to Alzheimer’s whilst screening participants for biomarkers that indicated that they had amyloid plaques.

The function of the treatment is to clear the brain of soluble amyloid, preventing it from forming into plaques. However, the failure of this method now draws into question whether this approach is enough to provide noticeable benefits to patients.

Researchers are not going to give up entirely on the compound, with plans to test the drug at higher doses to see if this can potentially make a more significant impact. It was noted that the decline of patients on solanezumab was 11% slower than those on placebo and, though this isn’t enough to be significant, it could offer hope of a stronger dose providing an increased benefit.

“Although we are disappointed that this particular drug did not prove successful, the field is benefiting from each study,” says lead author Lawrence Honig, Professor of Neurology at CUIMC. “There is hope that one of the newer ongoing studies may result in an effective treatment for slowing the course of Alzheimer's disease.”

The drug will be used in two prevention trials using the drug at higher doses for four years in asymptomatic participants. The patients studied will be in cognitively health people that possess a risk for Alzheimer’s to see if using the treatment in earlier stages of the disease may be more effective.

Ben Hargreaves

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