Disappointment as phase III aducanumab trials for Alzheimer’s disease stopped early

Medicine 1851178 1920

It was announced yesterday (Thursday 21st March) that pharmaceutical companies Biogen and Eisai are to discontinue two phase III trials of the Alzheimer’s disease drug aducanumab. Designed to assess efficacy and safety of the drug in patients with mild cognitive impairment or mild Alzheimer’s disease, results from the ENGAGE and EMERGE trials indicated that it was unlikely that sufficient improvement in memory would be seen. 

The feeling that the early reports on the clinical efficacy of Aducanumab were always presented in an over optimistic way, appears now to be right. Whilst the results are not entirely surprising, the disappointment in the field is still huge.
Professor Bart de Strooper, UK DRI Director

With increased understanding that many of the biochemical disease processes fuelling Alzheimer’s disease occur decades before the onset of symptoms, the industry has shifted trial design to target those at the earlier stages of disease. However, with the recent failure of multiple Alzheimer’s disease trials, it appears new thinking is required on drugs targets and even earlier detection and intervention essential. This is the approach that we are taking at the UK DRI: we are striving to fill the knowledge gap.

Professor John Hardy, UK DRI at UCL, said:
“It is very disappointing news that the amyloid antibody trial failed.  What this failure appears to teach us is that removing amyloid from the brain after it has deposited does little good.  This is the simplest explanation of the trial failure.  We will wait to see a more detailed analysis of the data from Eisai and Biogen and this may change our view: but this suggests that when people already are in the early stages of dementia, amyloid therapies alone will not work and we need new approaches. The UK DRI is investing in these other approaches. For amyloid therapies to work, we need to identify people before they start to lose nerve cells. Using genetics this may be possible and this is also work that is being done in the UK DRI and in other labs throughout the world.”

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