The announcement Tuesday night from Eisai and Biogen that their experimental medicine, lecanemab, reduced Alzheimer’s patients’ decline as measured by a clinical questionnaire is one of the biggest — and potentially happiest — shocks in the recent history of medicine.
It’s a shock because Biogen had so bungled the launch of their previous Alzheimer’s drug, Aduhelm, with failed clinical trials, a tortuous path to approval, and a wholesale rejection by Medicare and by the market. Wall Street analysts, who advise investors on what to buy, were not expecting success.
It’s even more of a shock because drug companies have been testing a litany of similar drugs for two decades without success. Proponents of these would-be medicines, which target peptides in the brain known as beta-amyloid, insisted with each new study that there were signs that the medicines were working and that a slightly better medicine was needed. But a growing chorus of voices seemed to think that this approach, often referred to as “the amyloid hypothesis,” was never going to work.
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