Anti-amyloid and Alzheimer's therapies
Solanezumab, a monoclonal antibody that binds to the monomeric or soluble form of amyloid-beta, is no better than placebo in slowing the progression of preclinical Alzheimer's disease (AD), results of a phase 3 trial show.
Although the study was negative, its design provides important clues for future trials.
The results indicate that you really need to decrease (amyloid) plaque .
The negative results are due to the type of monoclonal antibody used. Solanezumab doesn't bind to amyloid plaque; rather, it binds to a single amyloid protein. This is in contrast to other anti-amyloid therapies, including lecanemab, which binds to protofibrils or aggregated forms of amyloid and decreases plaque, and donanemab, which binds only to plaque.
The results of the Anti-Amyloid Treatment in Asymptomatic Alzheimer's Disease (A4) study, which is the first trial of its kind to enroll patients who were asymptomatic, also underlines the importance of early intervention.
The findings were presented at the Alzheimer's Association International Conference (AAIC) 2023 and were simultaneously published online July 17 in The New England Journal of Medicine.