New Alzheimers' treatment, Aducanumab, turns out to be just one more false hope for Alzheimer's patients

Image credit: Jr Korpa

The new drug, Aducanumab, even as of today’s date, 28 December 2022, is heavily touted by the Alzheimer’s Association:

[T]he first therapy to demonstrate that removing beta-amyloid, one of the hallmarks of Alzheimer’s disease, from the brain is reasonably likely to reduce cognitive and functional decline in people living with early Alzheimer’s.

Many other organizations have blindly endorsed the new drug, including the U.S. FDA. Yet the Canadian FDA has declined to approve it (and that won’t change).

But there are several problems:

1. The science supporting the notion that the beta-amyloid protein causes Alzheimer’s disease has not held up to time.

2. The medicine has shown zero ability to slow or prevent the actual symptoms of Alzheimer’s disease.

3. Insurance plans have declined to pay for this $56,000/year drug.

Duke Health provides a voice of sanity

Duke Health has provided a good summary of the issues with Aducanumab and why its pharmacy will not be offering it to its patients. According to Duke Health, although Aducanumab has shown an ability to reduce the presence of the amyloid protein, it is unclear whether the amyloid protein actually causes Alzheimer’s disease. Although the drug maker, Biogen, claims that the drug did work to reduce cognitive decline is some patient subgroups, overall it had no effect.

Explaining the fallacy of Biogen’s subgroup analysis

I am a meta-analyst, which means I specialize in studying research in aggregate, and I have personally exposed multiple cases of scientific fraud in my field of marketing science, so I will attempt to elaborate further. Biogen’s claims of the drug working for certain subgroups is very weak. Consider the following example, suppose you had a hypothesis that women are taller than men at the college you attend. So you measured all the men and women and compared heights and found that on average you were wrong. Instead of accepting that you are wrong, you decide to go around to each classroom to measure height of men and women in each classroom. In most classes the men are taller than the women but in a few classes, you found the opposite to be true. So now you claim that women are taller than men in some subgroups. Specifically, you claim that females are taller than men in industrial economics classes and identity politics classes. Obviously you found this only by random chance. This is the same weak foundation that Biogen’s claims rest on. They claim that—although it may not work generally, it may work for certain subgroups. This claim will not hold up to further testing that is specific to that subgroup just like your “women are taller than men” hypothesis will not hold up if you test it on the same classes for the next semester.

The fallacy of assuming that reduction in the amyloid protein can reverse the causes of Alzheimer’s disease

The biggest problem here is that scientists are not in agreement that the amyloid protein actually does cause Alzheimer’s disease. In fact, a recent scandal revealed that the original research that the whole idea was based on has turned out to be fraudulent. That’s right, the foundation of the field is a fraud. Scientists engage in fraud for many reasons including increased prestige and career benefits. But even if the whole concept were not based on fraud, the goal should not be to reduce a protein but to reduce cognitive decline. Since there is no evidence of the latter, the drug appears to be completely useless. Read more about the fraud case.

Conclusions

Still the best recommendation for staving off Alzheimer’s disease and cognitive decline generally appears to be lifestyle changes: exercise, diet, etc.

Also see:

• Brain Health FAQ: Can I reduce my risk of developing brain disease as I age?

• Why Physicians Should Not Prescribe Aducanumab for Alzheimer Disease