Alzheimer’s disease: Clinical trials and drug development
Abstract
Alzheimer's disease is the most common cause of dementia in elderly people. Research into Alzheimer's disease therapy has been at least partly successful in terms of developing symptomatic treatments, but has also had several failures in terms of developing disease-modifying therapies. These successes and failures have led to debate about the potential deficiencies in our understanding of the pathogenesis of Alzheimer's disease and potential pitfalls in diagnosis, choice of therapeutic targets, development of drug candidates, and design of clinical trials. Many clinical and experimental studies are ongoing, but we need to acknowledge that a single cure for Alzheimer's disease is unlikely to be found and that the approach to drug development for this disorder needs to be reconsidered. Preclinical research is constantly providing us with new information on pieces of the complex Alzheimer's disease puzzle, and an analysis of this information might reveal patterns of pharmacological interactions instead of single potential drug targets. Several promising randomised controlled trials are ongoing, and the increased collaboration between pharmaceutical companies, basic researchers, and clinical researchers has the potential to bring us closer to developing an optimum pharmaceutical approach for the treatment of Alzheimer's disease.
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γ-secretase inhibition has been associated with significant adverse effects due to its involvement in multiple physiological processes.
“Although nanoformulations have demonstrated potential in these areas, γ-secretase inhibition has been associated with significant adverse effects due to its involvement in multiple physiological processes.”
From Targeted Nanoparticles for Drug Delivery Across the Blood–Brain Barrier in Early and Late Stages of Alzheimer's Disease: A Review (2026) · cites this paper as [111]
Low bioavailability is considered one of the most important factors among the factors that explain the shortness of current agents used against Alzheimer's disease.
“The shortness of current agents used against AD can be attributed to several factors and low bioavailability is considered one of the most important ones among them [204].”
From Multi-Target Mechanisms of Phytochemicals in Alzheimer’s Disease: Effects on Oxidative Stress, Neuroinflammation and Protein Aggregation (2022) · cites this paper as [204]
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Evaluation of Dimebon in cellular model of Huntington's disease
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Immunotherapy Targeting Pathological Tau Protein in Alzheimer's Disease and Related Tauopathies
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Multifunctional Neuroprotective Derivatives of Rasagiline as Anti-Alzheimer's Disease Drugs
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Delineating the Mechanism of Alzheimer’s Disease Aβ Peptide Neurotoxicity
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Effect of a CYP2D6 polymorphism on the efficacy of donepezil in patients with Alzheimer disease
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Huperzine A protects isolated rat brain mitochondria against β-amyloid peptide
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Site-specific UBITh® amyloid-β vaccine for immunotherapy of Alzheimer's disease
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Towards Non Invasive Nerve Growth Factor Therapies for Alzheimer's Disease
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Back to the future: the 'old-fashioned' way to new medications for neurodegeneration
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Dimebon (Latrepirdine) Enhances Mitochondrial Function and Protects Neuronal Cells from Death
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Self-citationNogo receptor 1 regulates formation of lasting memories
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Self-citationWhy Did Tarenflurbil Fail in Alzheimer's Disease?
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The Quest for Small Molecules as Amyloid Inhibiting Therapies for Alzheimer's Disease
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NAP and D-SAL: neuroprotection against the β amyloid peptide (1–42)
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γ-Secretase: a complex target for Alzheimer's disease
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Alzheimers Disease Drug Development in 2008 and Beyond: Problems and Opportunities
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Can Lithium or Valproate Untie Tangles in Alzheimer's Disease?
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Amyloid‐beta reduction by memapsin 2 (beta‐secretase) immunization
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Review: Donepezil in Severe Alzheimer's Disease
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Self-citationCholesterol-modifying strategies for Alzheimer’s disease
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Self-citationAlzheimer's disease: γ-secretase inhibitors
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Emerging and potential therapies for Alzheimer's disease
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Cortical Changes Following Spinal Cord Injury with Emphasis on the Nogo Signaling System
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The Perils of Alzheimers Drug Development
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O2‐05‐03: Immunotherapy targeting abnormal protein conformation
Wısnıewskı, T., Prelli, F. C., Scholtzova, H., Chung, E., Mehta, P. D., Kascsak, R., Kascsak, R. J., & Goñi, F. (2009) · Alzheimer s & Dementia · doi:10.1016/j.jalz.2009.05.354 · Cited by 20 · see citing works
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Hilt, D. C., Gawryl, M. S., Koenig, G., & The EVP‐6124 Study Group (2009) · Alzheimer s & Dementia · doi:10.1016/j.jalz.2009.07.147 · Cited by 18 · see citing works
P1‐279: NIC5‐15 as a treatment for Alzheimer's: Safety, pharmacokinetics and clinical variables
Grossman, H. T., Marzloff, G. E., Luo, X., LeRoith, D., Sano, M. C., & Pasinetti, G. M. (2009) · Alzheimer s & Dementia · doi:10.1016/j.jalz.2009.04.287 · Cited by 17 · see citing works
O1‐04‐03: The ADCS valproate neuroprotection trial: Primary efficacy and safety results
Tariot, P. N., Aisen, P. S. S., Cummings, J. L., Jakimovich, L. J., Schneider, L. S. S., Thomas, R. G., Becerra, L. M., & Loy, R. (2009) · Alzheimer s & Dementia · doi:10.1016/j.jalz.2009.05.216 · Cited by 16 · see citing works
Tsakanikas, D., Shah, K., Flores, C., Assuras, S., & Relkin, N. R. (2008) · Alzheimer s & Dementia · doi:10.1016/j.jalz.2008.05.2422 · Cited by 14 · see citing works
Désiré, L., Marcade, M., Peillon, H., Drouin, D., Sol, O., & Pando, M. (2009) · Alzheimer s & Dementia · doi:10.1016/j.jalz.2009.04.276 · Cited by 14 · see citing works
O1‐04‐02: A clinical trial of docosahexanoic acid (DHA) for the treatment of Alzheimer's disease
Quinn, J. F., Raman, R., Thomas, R. G., Ernstrom, K. B., Yurko‐Mauro, K., Nelson, E. B., Shinto, L. H., Nair, A. K., & Aisen, P. S. S. (2009) · Alzheimer s & Dementia · doi:10.1016/j.jalz.2009.05.215 · Cited by 14 · see citing works
Wood, K. M., Lanz, T. A., Coffman, K. J., Becker, S. L., Deusen, J. V., Nolan, C. E., Richter, K. E. G., Finley, J. E., Brown, T. M., Brodney, M. A., et al. (2008) · Alzheimer s & Dementia · doi:10.1016/j.jalz.2008.05.1453 · Cited by 13 · see citing works
Schmechel, D. E., Gerard, G., Vatakis, N. G., Harper, L., Ross, J., Bari, M. A., Walling, D. P., Stedman, M., Winston, J. L., Morimoto, B. H., et al. (2008) · Alzheimer s & Dementia · doi:10.1016/j.jalz.2008.05.1455 · Cited by 13 · see citing works
Jacobsen, S. J., Comery, T. A., Kreft, A. F., Mayer, S. C., Zaleska, M. M., Riddell, D. R., Bard, J., Gonzales, C., Frick, G. S., Raje, S., et al. (2009) · Alzheimer s & Dementia · doi:10.1016/j.jalz.2009.05.472 · Cited by 12 · see citing works
Yurko‐Mauro, K., McCarthy, D., Bailey‐Hall, E., Nelson, E. B., Blackwell, A. D., & MIDAS Investigators (2009) · Alzheimer s & Dementia · doi:10.1016/j.jalz.2009.05.214 · Cited by 10 · see citing works
F1‐01‐04: Beta‐secretase as target for amyloid‐reduction therapy
Tang, J. (2009) · Alzheimer s & Dementia · doi:10.1016/j.jalz.2009.05.177 · Cited by 10 · see citing works
Madine, J., Wang, X., Brown, D. R., & Middleton, D. A. (2009) · ChemBioChem · doi:10.1002/cbic.200900219 · Cited by 10 · see citing works
Garzone, P. D., Koller, M., Pastrak, A., Jhee, S. S., Ereshefsky, L., Moran, S., Cedarbaum, J. M., Xu, V., & Ross, B. D. (2009) · Alzheimer s & Dementia · doi:10.1016/j.jalz.2009.04.526 · Cited by 10 · see citing works
P3‐243: The role for CSF dynabridging studies in developing new therapies for Alzheimer's disease
Ereshefsky, L., Jhee, S. S., Yen, M., & Moran, S. (2009) · Alzheimer s & Dementia · doi:10.1016/j.jalz.2009.04.1016 · Cited by 9 · see citing works
Wischik, C. M. (2009) · Alzheimer s & Dementia · doi:10.1016/j.jalz.2009.05.175 · Cited by 9 · see citing works
Maher‐Edwards, G., Zvartau-Hind, M. E., Hunter, A. J., Gold, M., Hopton, G., Jacobs, G., Davy, M., & Williams, P. M. (2010) · Current Alzheimer Research · doi:10.2174/1567210200438162050 · Cited by 9 · see citing works
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Bednar, M. M., Zhao, Q., Landen, J. W., Billing, C. B., Rohrbacher, K. D., & Kupiec, J. W. (2009) · Alzheimer s & Dementia · doi:10.1016/j.jalz.2009.05.542 · Cited by 7 · see citing works
Ito, K., Corrigan, B., Zhao, Q., French, J. L., Miller, R., & Fullerton, T. (2009) · Alzheimer s & Dementia · doi:10.1016/j.jalz.2009.04.274 · Cited by 7 · see citing works
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P1‐258: Prediction of treatment response to rivastigmine in Parkinson's Disease Dementia
Adler, G., Bektas, M., Ko-Inoshishi, Y., Tracik, F. M., & The RIVAPARK Study Group (2009) · Alzheimer s & Dementia · doi:10.1016/j.jalz.2009.04.266 · Cited by 4 · see citing works
P3‐242: The role of autophagy in potentially therapeutic copper complexes
Price, K. A., Lim, S. C., Patterson, B., Caragounis, A., Volitakis, I., Cherny, R. A., Masters, C. L., Barnham, K. J., Donnelly, P. S., Crouch, P. J., et al. (2009) · Alzheimer s & Dementia · doi:10.1016/j.jalz.2009.04.1015 · Cited by 4 · see citing works
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Self-citation
- Authors
- Mangialasche, F., Solomon, A., Winblad, B., Mecocci, P., & Kivipelto, M.
- Affiliations
- University of Perugia (IT)
- University of Eastern Finland (FI)
- Karolinska Institutet (SE)
- Corresponding author
- Winblad, Bengt
- Venue
- The Lancet Neurology
- Publisher
- Elsevier BV
- Published
- 2010-07
- Volume
- 9
- Issue
- 7
- Pages
- 702-716
- ISSN
- 1474-4422 (ISSN-L)
- OpenAlex
- W2129267808
- Cited by
- 1,217
- References
- 161
- Citations by year
- 2026: 31 · 2025: 47 · 2024: 53 · 2023: 45 · 2022: 91 · 2021: 80 · 2020: 69 · 2019: 77 · 2018: 82 · 2017: 79 · 2016: 78 · 2015: 89 · 2014: 121 · 2013: 97 · 2012: 80
- FWCI
- 8.96
- Type
- journal article
- Language
- en
- Update notices
- erratum (2011-06-01)
- Open access
- closed
- Locations
- The Lancet Neurology (publishedVersion)
- PubMed (publishedVersion)
- 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, clinical trials, disease-modifying therapy, symptomatic treatment, therapeutic target, pathogenesis, dementia, drug interactions, randomized controlled trials, translational research
- MeSH terms
- Alzheimer Disease, Clinical Trials as Topic, Humans, Antipsychotic Agents, Drug Design
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