Well, there it is. Biogen and Eisai have announced just this morning that they’re halting Phase III trials of aducanumab, their anti-amyloid antibody, after the monitoring committee judged that further treatment would be futile.
I’m not going to do some sort of victory dance, because (once again) this is bad news for Alzheimer’s patients and for their families. I know that I have written many times that I thought this program would fail – I was cautious in 2015, cautious earlier last year, and much more than cautious just a few weeks later. My views on amyloid antibodies are well known, for the little that’s worth. I had no real expectations that aducanumab would work, despite all the attempts at positive spin over the years, and by golly, it doesn’t work. That doesn’t make me a prophet – I think any objective observer would have to have come to the same conclusion. Biogen and Eisai put themselves into this situation, although they definitely made it worse by trying to pretend that things were going differently than they have for every single other amyloid antibody program ever. They have all failed. One after another, again and again.
Amyloid definitely has something to do with Alzheimer’s – there’s far too much evidence to dismiss. But the situation is clearly more complicated than people have hoped, because otherwise, all the attempts to address amyloid (via antibodies and otherwise) would have yielded some tiny bit of clinical benefit. They have not. All the talk, some of it very loud and confident-sounding, about how it’s really another amyloid species, it’s the oligomers, it’s the soluble oligomers, that the drugs would work if they were just dosed earlier, in different patients: none of it has ever worked out. Not once. Something is wrong with the way we’re thinking about Alzheimer’s and amyloid, folks, something is wrong. It’s been wrong for a long time and that’s been clear for a long time. Do something else.