Drug development for Alzheimer's disease: where are we now and where are we headed?
Open accessAbstract
Objective The aim of this article was to provide a survey of the clinical development of pharmacotherapy for Alzheimer's disease (AD).Methods A search of PubMed to identify pertinent English-language literature was conducted using the terms Alzheimer's disease AND clinical trials (2003-2008), dementia AND prevention AND clinical trials (2003-2008), and the chemical names of all compounds mentioned in articles on new drugs for AD published since 2005. www.ClinicalTrials.gov was searched for relevant trials. Abstracts of the 2008 International Conference on Alzheimer's Disease (ICAD) were reviewed for relevance, as were pharmaceutical company and AD advocacy Web sites. Articles selected for review were primary reports of data from preclinical studies and clinical trials.Results A large number of drugs with differing targets and mechanisms of action are under development for the treatment of AD. Phase III trials of Ginkgo biloba, NSAIDs, phenserine, statins, tarenflurbil, tramiprosate, and xaliproden have been completed, none of them demonstrating adequate efficacy. Encouraging results from completed Phase II trials of dimebon, huperzine A, intravenous immunoglobulin, and methylthioninium chloride were reported at ICAD 2008. Nineteen compounds are currently in Phase II trials, and 3 compounds (AN1792, lecozotan SR, and SGS742) failed at this stage of development.Conclusions Despite disappointing results from recently completed Phase III trials of several novel compounds, the extent and breadth of activity at all phases of clinical development suggest that new pharmacotherapeutic options for the treatment of AD will become available within the next decade.
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Recent clinical trials attempting to replicate benefits of Aβ immunotherapy seen in mouse models have been primarily unsuccessful in preventing early cognitive decline in AD patients despite significantly decreasing amyloid burden.
“Recent clinical trials attempting to replicate the benefits of Aβ immunotherapy seen in mouse models have been primarily unsuccessful in preventing early cognitive decline in AD patients despite significantly decreasing the amyloid burden”
From The mitochondria-targeted antioxidant MitoQ prevents loss of spatial memory retention and early neuropathology in a transgenic mouse model of Alzheimer’s disease (2011) · cites this paper as Sabbagh, 2009
The Bapineuzumab section reports cognitive improvements from Aβ immunotherapy in mouse models. The Completed Phase 2 Trials—Unsuccessful section reports no significant differences on several cognitive measures for AN1792 and plaque removal in a small post-mortem group, but not significantly reduced amyloid burden across clinical trials or prevention of early cognitive decline specifically. The bapineuzumab phase 2 results also include a trend toward cognitive benefit, so the paper does not establish the claim as a general account of recent trials. (LLM, conf=0.85)
Experimental — accuracy not yet measuredAn agent claimed to inhibit Aβ oligomer formation did not meet its primary endpoint and further development was discontinued.
“An agent claimed to inhibit Aβ oligomer formation did not meet its primary endpoint and further development was discontinued [257, 258].”
From The Alzheimer’s disease mitochondrial cascade hypothesis: progress and perspectives (2014) · cites this paper as [258]
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Matthews, B. R. (2010) · CONTINUUM Lifelong Learning in Neurology · doi:10.1212/01.con.0000368210.41093.4e · Cited by 15 · see citing works
Targeting the GABAB Receptor for the Treatment of Depression and Anxiety Disorders
Felice, D., O’Leary, O. F., & Cryan, J. F. (2016) · Springer eBooks · doi:10.1007/978-3-319-46044-4_12 · Cited by 13 · see citing works
Luo, J., Lee, S., VandeVrede, L. A., Qin, Z., Piyankarage, S. C., Tavassoli, E., Asghodom, R. T., Aissa, M. B., Fà, M., Arancio, O., et al. (2015) · BMC Neuroscience · doi:10.1186/s12868-015-0208-9 · Cited by 12 · see citing works
Toxicological scoring of Alzheimer’s disease drug huperzine in a guinea pig model
Pohanka, M., Zemek, F., Banďouchová, H., & Pikula, J. (2011) · Toxicology Mechanisms and Methods · doi:10.3109/15376516.2011.635320 · Cited by 12 · see citing works
Therapeutic Applications of Nicotinic Stimulation: Successes, Failures, and Future Prospects
NEWHOUSE, P. A. (2018) · Nicotine & Tobacco Research · doi:10.1093/ntr/nty189 · Cited by 11 · see citing works
- Authors
- Sabbagh, M. N.
- Affiliations
- Banner Sun Health Research Institute (US)
- Corresponding author
- Sabbagh, Marwan N.
- ORCID
- Sabbagh, Marwan N.
- Venue
- The American journal of geriatric pharmacotherapy
- Publisher
- Elsevier BV
- Published
- 2009-06
- Volume
- 7
- Issue
- 3
- Pages
- 167-185
- ISSN
- 1543-5946 (ISSN-L)
- PMC
- PMC2948028
- OpenAlex
- W2004845278
- Cited by
- 147
- References
- 95
- Citations by year
- 2026: 2 · 2025: 1 · 2024: 1 · 2023: 1 · 2021: 5 · 2020: 8 · 2019: 6 · 2018: 5 · 2017: 3 · 2016: 12 · 2015: 6 · 2014: 15 · 2013: 8 · 2012: 13
- FWCI
- 2.74
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- The American Journal of Geriatric Pharmacotherapy (publishedVersion)
- PubMed (publishedVersion)
- PubMed Central (acceptedVersion)
- Funders
- Pfizer
- National Institute for Health and Care Research
- Eisai
- National Health Research Institutes
- National Institutes of Health
- National Institute on Aging (P30AG019610)
- Topics
- Health Sciences › Medicine › Physiology › Alzheimer's disease research and treatments
- Health Sciences › Medicine › Psychiatry and Mental health › Dementia and Cognitive Impairment Research
- Health Sciences › Medicine › Pharmacology › Cholinesterase and Neurodegenerative Diseases
- Keywords
- Alzheimer's disease, drug development, pharmacotherapy, clinical trials, dementia prevention, Ginkgo biloba, nonsteroidal anti-inflammatory drugs, phenserine, statins, tramiprosate, dimebon, huperzine A, intravenous immunoglobulin, methylene blue
- MeSH terms
- Alzheimer Disease, Animals, Humans, Drug Design, Randomized Controlled Trials as Topic, Drug Delivery Systems, Clinical Trials, Phase II as Topic, Clinical Trials, Phase III as Topic
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