An exploratory study, conducted by NetNoggin®, revealed that among those impacted by Alzheimer's, hope of finding a cure is deflating due to recent clinical trial failures. This exploration was a combination of secondary analysis and primary netnographic research.
Since January 2018, Pfizer pulled out of the Alzheimer’s space and six clinical trials have been unsuccessful:
January 2018 - Eli Lilly/AstraZeneca discontinued lanabecestat
February 2018 - Merck discontinued verubecestat trials
January 2019 - Roche discontinued crenezumab trials
March 2019 - Biogen/Eisai discontinued aducanumab trials
July 2019 - Amgen/Novartis discontinued trials for CNP520
September 2019 - Neurotrope failed to meet Bryostatin-1 primary endpoints
Recently failed clinical trials have tested a variety of interventions for various stages of Alzheimer’s (request the full details here: https://netnoggin.net/exploratory-analysis). Secondary data suggests many of the failed clinical trials utilized the Alzheimer's Disease Assessment Scale-cognitive subscale (ADAS-Cog) or Clinical Dementia Rating–Sum of Boxes (CDR-SB) as the primary endpoint for the prodromal and/or early/mild stages. In addition, the only successful Alzheimer's drug that made it to market in the last decade was NAMZARIC, a drug based on compounding two drugs (memantine and donepezil) which were approved over a decade earlier. Manufacturers of Alzheimer’s medications acknowledge drugs currently on the market only treat the symptoms of Alzheimer’s, and do not halt nor reverse disease progression. As a result, frustration in the Alzheimer’s community continues to increase.
To better understand how the Alzheimer’s community is reacting to this news, NetNoggin® captured and analyzed ~14,500 online conversations by patients, caregivers, organizations, physicians, and researchers regarding Alzheimer’s drug failures from January 1, 2018 to September 19, 2019. General news channels led the majority of the market conversation volume; however, netnographic data suggests many general news posts initiated further conversation between researchers and caregivers alike. This primary netnographic data suggests that of the caregivers and patients with Alzheimer’s who respond online to Alzheimer’s drug failure news, most express negative emotions such as anger, dread, depression, pessimism, and hopelessness. However, unlike the negative response from caregivers and patients with Alzheimer’s, many organizations, researchers, and other community members express a wide variety of emotions, including hope and disappointment, regarding the news of drug failures.
In addition to observing the emotional reactions of the community, NetNoggin® captured their various hypotheses of why Alzheimer’s drugs are failing. For example, some community members believe the reasons are:
The amyloid hypothesis has been exhausted
Alzheimer’s will never be reversed by pharmacotherapies
Trial participants are too far along in the disease
Neurodegeneration of the human brain is not adequately understood
Additional hypotheses are listed in the full exploratory analysis.
NetNoggin® also captured suggested next steps regarding drug development discussed by the Alzheimer’s community:
Continue to research amyloids as a target (learning from failures)
Consider prevention as the best way to treat Alzheimer's
Further research BACE inhibitors with lower doses and at earlier disease stages
Explore the failed cancer drug, farnesyltransferase inhibitor, for Alzheimer's
Consider personalizing treatment (genetic research on CHRFAM7A genotype)
Continue to research other mechanisms and pathways of Alzheimer's
The Journal of Alzheimer’s Disease Editor in Chief, George Perry, states, “Critical next steps in Alzheimer's drug development must return to basics of understanding the biological role of amyloid and tau in brain aging. Not understanding how the brain continues to function into advanced age is a wonder we still barely understand and is likely at the root of Alzheimer's disease.”
We, as a community, need to clearly communicate the hope of finding a cure even among the drug failures. Learnings from Alzheimer’s drug failures and from other studies (including netnographic data) indicate there is an opportunity to increase Alzheimer’s drug success, specifically for therapies that reverse and/or prevent Alzheimer’s.