The search for new Alzheimer's treatments just faced another setback - here's where researchers are looking now
- It's been a while since we've had good news in search for new Alzheimer's drugs.
- On Tuesday, Merck said it was discontinuing one of its remaining trials that was looking at using the treatment in patients very early on in the disease.
- A number of trials are still ongoing, testing out new hypotheses to see if there's a way to tackle Alzheimer's better than we can today.
Things are pretty bleak in the search to find new Alzheimer's treatments.In February alone, the CEO of Axovant stepped down after 10 months on the job and a failed Alzheimer's trial. And Merck said it was cancelling a trial looking at Alzheimer's treatments in early stage patients, concluding that "it was unlikely that positive benefit/risk could be established if the trial continued."
A year ago, in February 2017, Merck stopped an earlier late-stage trial of verubecestat in patients with mild to moderate Alzheimer's, after a committee found that there was "virtually no chance of finding a positive clinical effect." The hope was to have the drug - a BACE inhibitor - stop the disease from progressing.
"In a way, the writing was on the wall," Bernstein analyst Tim Anderson said in a note Tuesday, after the latest cancellation. Anderson pointed to the fact that Merck's head of neuroscience had left the company in early 2018 as a sign that things likely weren't going well.
Alzheimer's affects more than 5 million Americans, a number that's expected to balloon to 13.8 million by 2050 . There are only four drugs that have been approved to treat the symptoms of the disease, and the most recent drug approval happened in 2003.
According to an industry report, there are more than a dozen experimental treatments that are still in phase 3, the latest stage of clinical trials before companies present their data to the FDA. Here are some of the ones to look out for in the next year or two.
- VTV Therapeutics, a small company in North Carolina, has an Alzheimer's drug in late-stage trials called azeliragon that inhibits the RAGE receptor, ideally helping people with mild Alzheimer's delay cognitive decline. Its phase 3 trial is expected to wrap up in early 2018. The company got encouraging phase 2 results on the drug, which has been in the works for about 17 years. Even so, there's no guarantee it will succeed. "We are doing a sound and rigorous experiment," Dr. Larry Altstiel, VTV's chief medical officer told Business Insider.
- Biogen's aducanumab, is going after the " amyloid hypothesis," or the idea that targeting beta amyloid deposits in the brain to clear them out is the way to go about treating the disease. It's expected to have results in 2019 or early 2020.
- Lanabecestat, AstraZeneca's BACE inhibitor, is going be reading out in 2019. Like Biogen, it's going after the amyloid hypothesis.
- Eli Lily's solanezumab failed a phase 3 trial in patients with mild dementia in November 2016, but has plans to keep trying the drug in pre-clinical stages of the disease to see if it works preventatively. Solanezumab is going after the amyloid hypothesis as well. While three trials have been disconnected, the fourth in this preventive setting is expected to have results in 2022.
- Genentech has two Alzheimer's drugs in late-stage development, despite hitting setbacks. In February, Genentech and its partner AC Immune launched a phase 3 trial for crenezumab, another drug that's targeting amyloid deposits in the brain. It's expected to have data in 2020. The other is gantenerumab, a drug also targeting amyloid that failed earlier trials. The hope is that by increasing the dose, it might work. Genentech started a new phase 3 trial for gantenerumab in 2017.