Failure of Lilly’s Solanezumab Not Seen as Conclusive Proof That Amyloid Theory Is Flawed

Failure of Lilly’s Solanezumab Not Seen as Conclusive Proof That Amyloid Theory Is Flawed
The Alzheimer’s community lamented Eli Lilly's recent announcement that its experimental therapy solanezumab failed to demonstrate efficacy in treating the disease in recent clinical trials. In the announcement, released Nov. 23, Lilly said it would not pursue regulartory approval for the drug. Solanezumab's inability to demonstrate effectiveness in people with mild demential due to Alzheimer’s disease, however, represents more than just a one-drug failure. After one amyloid-targeting drug trial disappointment after the other, some in the Alzheimer's community viewed the solanezumab trial as the final test of the amyloid hypothesis for treating Alzheimer’s disease. Lilly’s announcement gave critics of the amyloid theory plenty of reason for “I told you so” responses. Nevertheless, the hypothesis that amyloid-beta is the villain causing Alzheimer’s disease continues to have its supporters among researchers and caregivers alike, and numerous trials are still testing various drugs that aim to lower the levels of amyloid-beta as a way of preventing cognitive decline in patients. Solanezumab is an antibody that sweeps up soluble single molecules of amyloid proteins from the blood and cerebrospinal fluid, so they cannot go on to form plaques. Both animal studies and earlier human trials of the drug showed promising results. The EXPEDITION3 trial (NCT01900665) recruited more than 2,100 patients with mild Alzheimer’s dementia — a number that would be enough to prove the drug's effectiveness. After 18 months, however, results were only slightly leaning toward a favorable effect of solanezumab — not enou
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