Pharma's 'ill-considered' use of R&D resources in search for Alzheimer's therapeutics reviewed by NeuroPerspective

A comprehensive review of Alzheimer's therapeutics, and a critical assessment of the pharmaceutical industry's ill-considered allocation of R&D resources to date appears in the October issue of NeuroPerspective, released by NR Research this week.

While there has been some acknowledgment in the field that the amyloid is, at the very least, an incomplete mechanistic framework, and that tau may constitute a critical downstream component of the neurotoxic process, the flagship pivotal testing programs completed or underway have been amyloid-focused. Other potentially useful mechanistic approaches have often languished for lack of resources. A recalibration of what constitutes a comprehensive AD pipeline is required, which opens the door for therapeutics utilizing other mechanisms, such as those addressing tau, metal-binding, insulin, and neurotrophin-enhancement, the review notes.

The task of assessing the efficacy of therapeutic candidates has also been complicated by the uncertainty as to when, in addition to where, in the disease-process interventions can be effectively targeted. Some treatment failures may be due to the fact that they were “too little,” but it is also possible that several were “too late,” after irremediable damage has already been done. The hope is that addressing prodromal Alzheimer's, and the use of biomarkers, will allow for intervention when it can make a difference. However, there is at this point no truly validated molecular target, and no clinically proven biomarker for assessing drug effect on disease-progression.