CONFERENCE COVERAGE SERIES
Alzheimer's Association International Conference - 2021
Denver, Colorado and Online
26 – 30 July 2021
The FDA approval for aducanumab left clinicians with little guidance on how to select the right patients and ensure their safety. At this year’s Alzheimer's Association International Conference, leading clinicians presented appropriate-use recommendations that helped fill the void. These include not prescribing the drug to people with cerebral amyloid angiopathies or people on blood thinners, and monitoring vascular health with frequent MRIs. Clinicians welcomed the guidelines and were hungry for more.
Aducanumab: Will Appropriate-Use Recommendations Speed Uptake?
At AAIC, leading Alzheimer’s clinicians plug gaps in the FDA label. They urge exclusion of people with cerebrovascular risk, and an MRI monitoring bonanza. Meanwhile, clinical rollout starts slow, with major hospitals declining to administer.
On Donanemab, Plaques Plummet. Off Donanemab, They Stay Away
Data from a Phase 2 trial also suggested that when amyloid dropped in treated brain, plasma p-tau217 followed suit. Using a CAMD progression model, Lilly claims the biomarker responses correlated with slower decline.
Antisense Therapy Stifles CSF Tau in Mild Alzheimer’s Disease
Initial results from the first trial of an antisense oligonucleotide against tau in Alzheimer’s are in. BIIB080 appears safe and curbed total tau and phospho-tau 181 levels in the CSF. Clinical outcomes were not assessed.
Seeking Real-World Data on Whether Aducanumab Works
Biogen sponsors an observational study on the drug’s effects; no word yet on the FDA-required Phase 4 trial. Meanwhile, researchers suggest other ways to test efficacy.
Will Insurance Cover Aducanumab? Jury Is Out
While payers public and private are deliberating whether or not to cover this first-in-class drug, the health economics group ICER re-affirms its original conclusion that aducanumab is overpriced.
Lecanemab Post Hoc: Is Continual Treatment Required for Cognitive Benefit?
Patients taken off the drug continue to outperform those who were never on it, and decline slows even more once treatment resumes. Cognition and plasma Aβ changes are consistent with disease-modifying effect.
Aduhelm Approval Reverberates Through Research
Scientists worry about trial recruitment and retention, and discuss whether upcoming trials should allow aducanumab as a background therapy.
Flurry of Investigations Besets Aducanumab
In the wake of the controversial thumbs-up for Aduhelm, the U.S. federal government is probing not only aducanumab’s price and approval history, but also the FDA’s accelerated approval pathway in general.
AL001 Boosts Progranulin. Does it Slow Frontotemporal Dementia?
In an open-label Phase 2 study, fluid biomarkers suggested the anti-sortilin antibody restored lysosomal function and reduced neuroinflammation in people with symptomatic FTD. Tantalizingly, participants worsened less than historical controls.
Up-and-Coming Immunotherapies Target Aβ and Tau
Scientists are testing passive and active immunotherapies that take down pyroglutamate Aβ, and a combo Aβ/tau vaccine.
ADAD and LOAD: At Cellular Level, They Are Not the Same
Single-nuclei expression analysis identified different cell clusters from people who carried autosomal-dominant Alzheimer’s mutations or risk variants for late-onset AD. Also, microglia RNA-Seq goes big.
Polygenic Scores Paint Microglia as Culprits in Alzheimer's
AD risk scores based on gene expression in microglia associate with having amyloid plaques, and a microglial genomic atlas displays how variants influence gene expression. Polygenic variation in neurons sways cognition.
Mirror, Mirror on the Wall, Who’s the Earliest of Them All?
Decades before tangles become rampant, the biomarker p-tau231 rises in both CSF and plasma. More surprising: neuroinflammation markers do, too.
Aβ, Tau, and Other AD Markers Altered in COVID
Markers of neuronal injury rose in plasma within a few months of severe COVID-19, then fell back to normal by six months. Some cases with brain symptoms had lower Aβ and higher tau in their blood.