RESEARCHING FALL 2018 ALZHEIMER’S MEDICINES
FALL 2018RESEARCHINGALZHEIMER’SMEDICINESSETBACKS AND STEPPING STONESfullc olorb l ackwhite
RESEARCHING ALZHEIMER’S MEDICINES: SETBACKS AND STEPPING STONESForewordIn recent years, a dearth of new treatments for Alzheimer’s disease has left many to conclude that a cureis out of reach. As this report demonstrates, there’s no doubt that setbacks are inevitable and instructivewhen tackling a complex disease like Alzheimer’s. But given the increase in understanding of the diseasein the past few years and the steady rise in Alzheimer’s treatments in development, patients and theirfamilies have good reason to be optimistic.In fact, a recent analysis of late stage Alzheimer’s drugs, conducted by ResearchersAgainstAlzheimer’s, aglobal network of leading researchers, found nearly a hundred treatments in Phase 2 and 3 developmentin 2018. The analysis demonstrates that the drugs in development are increasingly attacking the diseasein different ways – an important fact given that successful future treatments will likely rely on multipletherapies to stop the disease.And yet despite the diversity of treatments in development, there is a shortage of geriatricians to carefor the country’s aging population, patients are commonly misdiagnosed, there continue to be long waittimes to see neurologists, racial disparities persist, and many patients are never told of their diagnosisby their doctor. Additionally, primary care practices are not equipped, trained, or incented to build brainhealth practices into routine standards of care. This lack of preparation and training has led to a shortageof treatments for cognitive impairment, an oversight of potential risk reducing behaviors, and often lateand inaccurate diagnosis of Alzheimer’s.These signs all indicate that the U.S. healthcare system may not be prepared to administer noveltreatments to patients when they become available. As the science progresses, physicians, lawmakers,advocates, and industry leaders must work together to ensure we’re all ready for life-saving treatments.From polio to HIV/AIDS, past global health efforts have taught us that we can successfully tacklechallenging healthcare issues if we are focused and collaborative. And at a time when the global impactof Alzheimer’s is sharply rising, it’s now more important than ever that the Alzheimer’s community –including researchers and advocates – come together to accelerate a cure.As millions of patients and their families in the U.S. and abroad continue to hold out hope for a cure, timeis of the essence. We shouldn’t waste another minute.Sincerely,George VradenburgCo-Founder and ChairmanUsAgainstAlzheimer’s2
Executive SummaryAlzheimer’s disease is a devastatingillness that gradually robs a person ofeverything they hold dear: their memories,their relationships, their personality, theirindependence, and, ultimately, their life.Family and caregivers face many challengesas they care for a loved one who is graduallyslipping away. Alzheimer’s also places asignificant burden on the health care systemat-large. As the aging population expands,so does the need to address and conquerAlzheimer’s disease. Without progress, thecost and resource burden of Alzheimer’s willcontinue to grow, and countless individualsand families will be impacted.To treat, slow, and prevent Alzheimer’sdisease, new treatments are urgentlyneeded. Biopharmaceutical researchcompanies are studying many potentialnew treatments. However, the path frombasic research to the development of newmedicines is extremely long and complexwith many setbacks along the way. This isparticularly true in the case of Alzheimer’sdisease, where diagnosis is challenging, andwe lack a full understanding of the disease.A new analysis finds that between 1998and 2017, there were 146 unsuccessfulattempts to develop medicines to treatand potentially prevent Alzheimer’s. In thatsame timeframe, only four new medicineswere approved to treat the symptoms ofAlzheimer’s disease. In other words, forevery research project that succeeded,about 37 failed to yield a new medicine.Although these setbacks are deeplydisappointing, they provide criticaldata that inform future research efforts.Medical research is often iterative, withbreakthroughs rarely happening overnight.In fact, lessons learned from unsuccessfulprojects help inform potential new scientificavenues to explore in future researchefforts. Progress in Alzheimer’s drugdevelopment will undoubtedly be the resultof successes informed by setbacks.That said, as critical as setbacks are toresearchers, they are nonetheless costlyand illustrate the long and arduous processof developing medicines for diseases ascomplex as Alzheimer’s. Recognizing therisk and significant scientific uncertaintiesinvolved in Alzheimer’s research and theurgent need for progress, it is imperative thatwe have a policy and regulatory frameworkthat supports a robust research enterpriseand encourages innovators to take risks andaccept the inevitable setbacks.Despite the difficultiesand setbacks that thefield has experiencedin Alzheimer’s drugdevelopment, withperseverance, wecan illuminate thecomplexities of thisdisease and eventuallyfind a diseasemodifying medicine.”George Vradenburg, Chairman at UsAgainstAlzheimer’s1Biopharmaceutical researchers and thecompanies they work for are profoundlycommitted to leveraging the promise ofour expanding scientific knowledge to findtreatments that halt or prevent Alzheimer’s.Companies are currently working on 92medicines for the treatment of Alzheimer’sand other dementias, giving current andfuture patients and their families hope for afuture free of this devastating disease.3
RESEARCHING ALZHEIMER’S MEDICINES: SETBACKS AND STEPPING STONESIntroductionAlzheimer’s disease is the most commoncause of dementia resulting in significantproblems with memory, thinking, andbehavior. It is a growing health care burdenof epidemic proportions. Despite significanteffort and investment, the quest to developan effective disease-modifying medicine totreat or prevent this devastating and complexdisease has resulted in many failures.Developing new medicines is critical totackling Alzheimer’s disease, but theprocess of bringing innovative therapiesfrom an early idea to patients is as complexas the disease itself. What many do notrealize is that behind every medicine thatmakes it to patients, there are many morethat did not. In fact, across all diseases, only12 percent of drugs that enter clinical trialswill eventually reach approval.2While these setbacks are inevitable anddisheartening for patients and researchersalike, they can lead to new learnings thatadvance our research efforts going forward.This report highlights the burden ofAlzheimer’s disease, the unique challengesof developing medicines to treat or slowits progression, and the setbacks andadvances that have occurred as a result ofour efforts to conquer this devastating andincreasingly costly illness.There’s a revolution underway in the Alzheimer’s research world. At the heart is a change in the wayresearchers and regulators define and stage the disease, and it might just lead to the breakthroughAlzheimer’s researchers, patients and families have been waiting for.”Gary Tong, US Therapeutic Area Head, Dementia at Lundbeck3The Impact of Alzheimer’s Disease:Patients, Society, the EconomyAlzheimer’s disease gradually robs a personof everything they hold dear: their memories,their relationships, their personality, theirindependence, and, ultimately, their life.Many of us know someone — a grandparent,a friend, or loved one — who has beendiagnosed with this debilitating disease. Wehave seen their symptoms progressivelyworsen over time to the point where theyrequire around-the-clock care and mayeventually succumb to the disease.4According to the Alzheimer’s Association,about 5.7 million Americans are currentlyaffected by Alzheimer’s dementia, thesymptomatic phase of the disease.4 Today,it is the sixth leading cause of death in theUnited States, although studies suggest thatAlzheimer’s deaths are underreported.5Alzheimer’s also places a significantburden on the health care system at-large.Currently, Alzheimer’s disease and otherdementias account for 277 billion eachyear in direct medical costs.6
SOCIETY’S GREAT CHALLENGE76TH LEADINGcause of death in the U.S.5.7MILLIONAmericans impacted 277 BILLIONeach year in direct medical costs16.1 MILLIONcaregivers providing 232.1 billionin uncompensated care1 IN EVERY 5 MEDICARE DOLLARSgoes towards care for patients with Alzheimer’s dementia85
RESEARCHING ALZHEIMER’S MEDICINES: SETBACKS AND STEPPING STONESThe prospect of beingable to offer meaningfuldisease-modifyingtherapiesto individuals sufferingfrom this terribledisease is both excitingand humbling.”Alfred Sandrock, ExecutiveVice President and ChiefMedical Officer at Biogen17Adding to the challenges of Alzheimer’s is theuniquely significant toll it takes on a patient’sfamily and friends, who are often required tostep in as caregivers. As a result, the indirectcosts of the disease are enormous: nearly18.4 billion hours of uncompensated carewere provided by an estimated 16.1 millioncaregivers in 2017 — valued at approximately 232.1 billion.9 This figure does not include thelost productivity of caregivers who must leavethe workforce to care for a loved one.African Americans and Latinos are, onaverage, less likely than white Americans tobe diagnosed with Alzheimer’s by a healthcare professional.12Looking ahead, projected costs ofthis disease are expected to growexponentially as the patient populationcontinues to rise. Without a diseasemodifying treatment, experts predict thenumber of Americans with Alzheimer’scould reach a total of 13.8 million patientsby 2050.13 As a result, the direct costs ofAlzheimer’s disease will likely balloon to 1.1 trillion by that same year.14The impact of Alzheimer’s disease onspending in the Medicare program isespecially pronounced. In 2018, Medicareis projected to spend 140 billion ontreating patients with Alzheimer’s and otherdementias.10 This equates to about one inevery five Medicare dollars being spenton Alzheimer’s.11New disease-modifying treatments,however, could dramatically reduce theprojected economic and societal burden ofAlzheimer’s. According to the Alzheimer’sAssociation, if a new treatment that delaysthe onset of Alzheimer’s by five years isapproved by 2025, the number of peoplein the U.S. with the disease could bereduced by approximately 40 percent.15 Thedevelopment of such a treatment could savean estimated 367 billion a year by 2050(See chart below).16Often overlooked is Alzheimer’sdisproportionate impact on communitiesof color. In fact, African Americans aretwo times more likely and Latinos are oneand a half times more likely to developAlzheimer’s than non-Hispanic whiteAmericans. Despite this higher prevalence,Projected Impact of a Medicine that DelaysAlzheimer's Disease Onset by 5 Years, 2015-2050Cost in Billions of Dollars 1,200 1,000 800 600 400 200 02015202020252030Current Trajectory2035204020452050Delayed OnsetSource: Alzheimer’s Association, “Changing the Trajectory of Alzheimer’s Disease: How a Treatment by 2025 Saves Lives and Dollars,” May the-trajectory-r.pdf6
Our Current Understanding of Alzheimer’sWhile many of the biological causes andunderpinnings of Alzheimer’s remain amystery, our understanding of many aspectsof the disease, including potential ways todetect, attack or prevent it, has advanced inrecent years.Molecular and Genetic UnderpinningsResearch to date shows that there aretwo hallmarks of Alzheimer’s disease: theaccumulation of amyloid protein in the brainand the formation of tangled bundles offibers within brain cells (neurons).18Many individuals with Alzheimer’s presentwith an abnormal build-up of fragmentsof a protein called beta-amyloid, referredto as “plaques.” These plaques tend toaccumulate in the spaces between neurons.Another characteristic of Alzheimer’s is thedevelopment of “neurofibrillary tangles,” orclumped, twisted masses of protein fibers.These fibers consist of a protein called tau.19,20The protein plays a key role in the formationof microtubules, structural components ofbrain cells that help transport nutrients andprovide cell structure. Both of these changesoften take place in regions of the brain thatsupport memory and can lead to neurondamage and death — potentially contributingto the memory loss that is seen amongAlzheimer’s patients.While researchers have enhanced theirunderstanding of the molecular changescharacterizing Alzheimer’s, numerousquestions remain.21,22 For example, it isunclear whether the development ofamyloid plaques and tau tangles arecauses or symptoms of the disease.23Scientists believe some of these molecularchanges may have a genetic component.An estimated 1 percent or less of Alzheimer’scases develop as a result of mutations to anyof three specific genes involving the amyloidprecursor protein (APP) and the genes for twoadditional proteins, called presenilin 1 and2. Individuals that inherit specific mutationsin either the APP or presenilin 1 genes areguaranteed to develop the disease whilethose with a mutation in the presenilin 2 genehave a 95 percent chance of developingthe disease.24 Mutations in other genes andthe extra copy of chromosome 21, whichcharacterizes Down syndrome, are other lesscommon genetic changes that may affectone’s risk of Alzheimer’s.25In combination with genetic factors,environmental and lifestyle factors arealso believed to contribute to Alzheimer’sdisease. Studies have shown that regularphysical activity and management ofchronic diseases, such as diabetes, obesity,and hypertension, may reduce the risk ofcognitive decline and dementia.The more accuratelywe can characterizethe specific diseaseprocess pathologicallydefined as Alzheimer’sdisease, the betterour chances ofintervening at anypoint in this continuum,from preventingAlzheimer’s to delayingprogression.”Richard Hodes, Directorat the National Instituteon Aging30Reflecting the complexities of neurologicaldiseases, much of the biology behindAlzheimer’s disease is unknown. However,scientists continue to gain insights that mayinform new ways of diagnosing, preventing,and treating this disease.Diagnosis and Treatment OptionsAlzheimer’s disease develops well beforepatients develop the symptoms associatedwith Alzheimer’s dementia. In fact, researchsuggests that brain changes associated withthe disease may begin 20 or more yearsbefore symptoms appear.26,27,28,29 Cliniciansare increasingly using biomarkers – abiological characteristic that is objectivelymeasured and evaluated as an indicatorof disease – to help diagnose patients inclinical practice and identify patients toparticipate in clinical trials, although more7
RESEARCHING ALZHEIMER’S MEDICINES: SETBACKS AND STEPPING STONESare needed to better diagnose and monitorthe disease.31modifying treatments for Alzheimer’s, whichremain elusive.While there is no single test for Alzheimer’s,physicians currently use a variety of toolsto help diagnose the disease. Two imagingtechniques include positron emissiontomography (PET) and single-photo emissioncomputed tomography (SPECT). PET is usedin combination with various radioactivetracers to help visualize amyloid plaques andneurofibrillary tangles in the brain.32 SPECTcan help differentiate Alzheimer’s disease fromother brain conditions, such as depression.33There are currently five Food and DrugAdministration (FDA) approved medicinesfor Alzheimer’s disease, all of whichare used for symptom management byhelping to maintain mental function andcontrol behavioral symptoms.35 Of theexisting FDA approved medicines, mostare used in the treatment of moderateto severe Alzheimer’s and work to inhibitcholinesterase, which may help preservememory and thinking.36,37 Medicines usedto treat moderate to severe Alzheimer’sattempt to mitigate brain cell death.38However, non-imaging biomarkers areneeded to advance our capabilities to moreeasily monitor disease progression andresponse to treatment as well as improvethe rigor and efficiency of clinical trials.34Potential non-imaging biomarkers includemolecules measured in the blood, urine,cerebrospinal fluid, or other parts of thebody. More advanced diagnostic toolscould also aid in efforts to develop disease-The development of innovative medicines toprevent or slow the onset and progressionof Alzheimer’s disease would have aprofound impact on the lives of millions ofpeople. Researchers across the country inbiopharmaceutical companies, academia,and government are determined to developsuch treatments.Efforts to Advance Early DetectionDeveloping new ways to diagnose the disease will be critical to identifying patients in the early stages of Alzheimer’s, and toultimately provide them with treatments to prevent or delay disease progression. According to the Alzheimer’s Association,advances in early detection capabilities could save the U.S. an estimated 7.9 trillion.39Researchers are tirelessly searching for more simple and accurate biomarker tests for Alzheimer’s. For example, in recent clinicaltrials, investigators used PET imaging and magnetic resonance imaging (MRI) as a way to confirm the diagnosis of the diseaseas well as to identify potential disease-modifying effects in research patients.40 Other early detection studies focus on identifyingbiomarkers that indicate rising levels of beta-amyloid and tau in the brain, as well as neuron damage or deterioration.41Investigators are simultaneously exploring early detection strategies targeting other potential biological pathways for Alzheimer’s. Forexample, given research indicating that impaired glucose processing increases the risk of dementia, studies are using a combination ofPET imaging and the radioactive tracer fluorodeoxyglucose to measure the amount of glucose metabolism in the brain.42In addition to identifying patients for clinical trials, scientists believe that biomarkers will eventually be critical to identifyingindividuals with early-stage Alzheimer’s and monitoring the effects of treatment.43 Thus, as our ability to reliably diagnose thedisease advances, so does our ability to develop effective treatments.8
Eric Karran BiographyEric H. Karran PhD is a molecular biochemist by training. He is currently at AbbVie where he is VicePresident, Distinguished Research Fellow and Site Head of the Foundational Neuroscience Center inCambridge, Boston. Previously Eric was the Director of Research for Alzheimer’s Research UK. Hehas held senior positions in a number of companies, including SmithKline Beecham (now GSK),Pfizer, Eli Lilly and at Johnson and Johnson. Eric has specialized in Neuroscience research,particularly Alzheimer’s disease and other neurodegenerative diseases, for the past 20 years. Eric isa Visiting Professor in the Department for Human Genetics at the Catholic University of Leuven,Belgium; and at the Department of Molecular Neuroscience at the Institute of Neurology,University College London.On the Front Lineswith Eric Karran, Vice President, Foundational Neuroscience Centerat AbbVieQWhat do we understand about the underlyingcauses of Alzheimer’s?AWhat we believe is that a small protein calledAbeta starts to deposit in the brain to formabnormal aggregates called plaques. Thatseems to be the first thing that occurs in thebrain. And for reasons we don’t fully understand,that provokes a response in the brain wherebyanother pathology called tau tangles formsin neurons and then spread throughout thebrain. This starts in one part of the brain, calledthe entorhinal cortex, which is very importantin memory consolidation and retrieval. Butthen it spreads throughout the brain ultimatelycausing the cognitive decrements that we see inAlzheimer’s disease — loss of memory, loss ofthe ability to make decisions, and ultimately lossof language.QWhat role does genetics play in Alzheimer’sdisease and how does that impact ourresearch and the types of treatments thatwe are pursuing?AGenetics has been really important inAlzheimer’s disease and a lot of this was workedout in the 1990s. What scientists discoveredwas that a single change to a gene called theamyloid precursor protein was able to initiateearly Alzheimer’s disease with 100 percentcertainty. So, this was a very, very importantclue that this process — which ultimatelyleads to the amyloid plaque — is criticallyimportant in Alzheimer’s disease. And with thatunderstanding, we were able to design animalmodels in species like the mouse that have someof the pathology of Alzheimer’s disease. And inturn that has enabled us to test compounds andtherapeutic approaches to either delay or clearthe amyloid from the brain. These therapeuticapproaches have been or are now being testedin human clinical studies.QHow has our understanding of complexneurodegenerative diseases evolved overthe past years?AWhat’s really changed is the recognition that thedisease process starts very early on in peopleand it precedes the actual symptoms that theysuffer from by about 10 to 20 years. This isincredibly important because it shows us that formedicines to be effective we need to find a wayto treat people even before they present withclinical symptoms. And that has driven a wholelot of the science that we call biomarkers. Theseare things that you can measure that correlatewith disease process. And we ultimately hopethat we can measure some of these pathologicalprocesses going on in the human brain withimaging agents.9
RESEARCHING ALZHEIMER’S MEDICINES: SETBACKS AND STEPPING STONESChallenges of Developing Alzheimer’s MedicinesThe lack of progressin the treatmentand prevention ofAlzheimer’s disease isfrustrating for patients,families, physicians,researchers, industry,funders, and policymakers. Understandingthe causes for thesefailures is essential forinforming future trials.”David A. Bennett,Physician at Rush Alzheimer’sDisease Center45Despite the critical need, developing amedicine to prevent, delay, slow, or cureAlzheimer’s disease is exceptionallydifficult. Years of research have yieldedonly a handful of medicines providingpartial symptomatic relief. Successfuldisease-modifying treatments continue toelude the research community for severalreasons, including limitations of preclinicalmodels, the absence of validated,non-invasive biomarkers, clinical trialchallenges, and, above all, a significantgap in scientific knowledge.Adding to these challenges, manyresearchers believe that no single medicinewill be able to defeat Alzheimer’s. Rather,several medicines will likely be needed tocombat the disease.44Significant Gap in Scientific KnowledgeScientists still do not have a fullunderstanding of the underlying causesand mechanisms of Alzheimer’s disease.In fact, it is unknown whether many ofthe defining molecular characteristicsof the disease are causes, effects, orsigns of progression. This knowledge gapcompounds the challenge of identificationand selection of viable targets fornew medicines.Constraints of Preclinical ModelsCurrent preclinical models (e.g., animalmodels) of Alzheimer’s disease are limited inthe extent to which they can be extrapolatedor translated to the human condition.Improved models are needed to facilitatepreclinical testing of drug candidates andbetter predict their effects in humans.Limitations in Early DiagnosisWithout validated, non-invasive biomarkers,it is difficult to identify disease presence,often resulting in diagnosis being delayeduntil symptoms become more pronounced.In the context of clinical trials, this makes itparticularly challenging to identify eligiblepatients and enroll and retain them inclinical trials. It also makes it challengingto assess the effects of drug candidates.Ultimately, this leads to long and veryexpensive clinical trials.Overcoming these challenges is crucialto the success of drug development inAlzheimer’s. Given the complexity of thebasic research and technologies thatenable drug development, collaborationacross multiple stakeholder groups —including the biopharmaceutical industry,government, academia, patient advocacyorganizations, and disease foundations— is important to advancing the fieldas a whole. (See “Collaboration: Key toInnovating Medicines and Identifying NovelBiomarkers” on page 11.)10
COLLABORATIONKey to Progress Against Alzheimer’sTackling a disease as complex as Alzheimer’s willrequire the combined efforts and brainpower ofresearchers across institutions. Biopharmaceuticalcompanies are collaborating with patient advocacygroups, government agencies, and others in thehopes of soon delivering therapeutic advancementsto Alzheimer’s patients. Below are three examples ofinnovative partnerships that are bringing together thebrightest minds to overcome one of society’s greatchallenges.UsAgainstAlzheimer’s AD-PACE ProgramIn May 2018, UsAgainstAlzheimer’s launched a multiphased collaborative with pharmaceutical companies,advocacy organizations, academic institutions, andcare services organizations to identify and prioritize theneeds and preferences of those living with and affectedby Alzheimer’s disease. The partnership, Alzheimer’sDisease Patient And Caregiver Engagement (AD-PACE),brings together Alzheimer’s patients and caregiversto ensure that their perspectives are integrated intoclinical trial design, drug development, regulatoryreviews, payer value models, coverage and paymentdeterminations, and research on care and services.According to Ian Kremer, Executive Director of theLeaders Engaged in Alzheimer’s Disease (LEAD)Coalition, the collaboration is grounded in the beliefthat “every stage of Alzheimer’s drug developmentshould be centrally-informed by the preferences andpriorities of people living with the disease.”Accelerating Medicines Partnership –Alzheimer’s DiseaseThe Accelerating Medicines Partnership for Alzheimer’sDisease (AMP-AD) is a collaboration among governmentagencies, including the National Institutes of Health(NIH) and FDA, 12 biopharmaceutical and life sciencescompanies, and several nonprofit organizations.46Alzheimer’s disease is one of the three target diseaseareas for the partnership. AMP-AD focuses onadvancing the discovery of novel, clinically relevanttherapeutic targets and the development of biomarkersto help validate existing therapeutic agents.AMP-AD’s approach is two pronged. First, researchersare exploring the utility of tau imaging and novelbiomarkers in indicating response to treatment. AMPis providing supplemental PET imaging and fluidbiomarkers for three large, ongoing clinical trials,allowing the researchers to gain additional informationon the ability of these techniques to track the impact oftreatments.47 The second prong is an effort to acceleratethe discovery and validation of disease drug targetsby creating a large network of data, pooling molecularinformation from more than 2,000 patients. These dataare available to researchers.AMP’s ultimate goal is to shorten the time betweenthe discovery of a target and the development of aneffective new medicine.48Alzheimer’s Disease Neuroimaging InitiativeThe Alzheimer’s Disease Neuroimaging Initiative(ADNI) launched in 2004 as a collaboration initiativebetween the NIH and other federal agencies, nonprofitorganizations, and biopharmaceutical companiesto develop ways to detect Alzheimer’s disease atits earliest stages and track its progression throughbiomarkers. This work is designed to support andspeed up the development of new therapies by makingit possible to measure their effects more readily andselect patients in early stages of the disease that maybenefit the most.Data collected from ADNI are made available at nocost to researchers to use as they design Alzheimer’sdisease clinical trials and related research efforts.4911
RESEARCHING ALZHEIMER’S MEDICINES: SETBACKS AND STEPPING STONESThe Nature of Alzheimer’s Research:Setbacks and Stepping StonesDespite numerous studies and significantinvestment by biopharmaceuticalcompanies and others, setbacks continueto outnumber successes in Alzheimer’s drugdevelopment.In general, few candidate medicines reachpatients — only 12 percent of all medicinesthat enter clinical trials will eventually beapproved by the FDA.50 While by somemeasures trials that do not produce viabletherapies may be considered “failures,”these setbacks can be tremendouslyvaluable, as they provide crucial insightsthat help shape future research efforts.As the data from a negative outcome areanalyzed, the key findings are applied in thedesign of new studies and approaches, untilultimately a successful outcome or proof-ofconcept for a new therapy is achieved.Although every discontinued or suspendeddrug development project is extremelydisappointing, progress is the result ofsuccesses and setbacks. Medical researchis often iterative, and breakthroughs rarelyhappen overnight.A failed experiment is the only one that does not give you more information. These aren’t failuresbecause we are still learning so much about the brain. They are putting us on the road to pursueprogress together.”Phyllis Ferrell, Vice President of the Global Alzheimer’s Disease Team at Eli Lilly and Company5112
Though deeply disappointing for both patients and researchers,these setbacks offer important insights that inform and redirectfuture research efforts. Patients with neurological conditions have atremendous need for new treatments. Our industry is committed totackling these devastating and complex conditions.”Darryle Schoepp, Vice President of Neuroscience Discovery Pre-Clinical EarlyDevelopment at Merck52Researchers Perspectives on SetbacksIt is difficult to quantify the ways that research setbacks contribute to eventual successesin developing a new treatment, but researchers attest to the insights gained through theseefforts. For example:In 2016, Eli Lilly and Company halted the Phase 3 clinical trial for solanezum
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disease and/or the entire continuum of the disease. The term "Alzheimer's dementia" is used to describe those in the dementia stage of the continuum. Thus, in most instances where past editions of the report used "Alzheimer's disease," the current edition now uses "Alzheimer's dementia." The data examined are
Younger-onset (or early-onset) Alzheimer's disease affects people who are under age 65. Many people with younger-onset are in their 40s and 50s. They have families, careers, or are even caregivers themselves when Alzheimer's disease strikes. Up to 5 percent of people with Alzheimer's have younger-onset. In the United States,
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ENFERMEDAD DE ALZHEIMER Y OTROS TIPOS DE DEMENCIA Enfermedad de Alzheimer Más de 5 millones de estadounidenses padecen la enfermedad de Alzheimer, la forma más común de demencia, que representa del 60 al 80 por ciento de todos los casos. Eso incluye al 11 por ciento de las personas de 65 años o más y un tercio de las personas de 85 años o .
What If There Was a Cure for Alzheimer’s Disease and No One Knew? Dr. Frank Shallenberger’s Vol. 8, No. 12 December 2009. fact, in some people, this discovery com-pletely cures their Alzheimer’s. Steve’s case I know it sounds incredible — even unbelievable — to say that Alzheimer’s is
ANSI A300 Part 4 ( American National Standards Institute, Standard for Lightning protection Systems For Trees ) recommends designing the earth (ground) termination based on a visual inspection of the soil and its moisture content. This is not possible as water is an insulator not a conductor; it is the dissolved salts in the water that give it its conductive properties. These salts are not .
