Translation of Pre-Clinical Studies into Successful Clinical Trials for Alzheimer’s Disease: What are the Roadblocks and How Can They Be Overcome?
Open accessAbstract
Preclinical studies are essential for translation to disease treatments and effective use in clinical practice. An undue emphasis on single approaches to Alzheimer’s disease (AD) appears to have retarded the pace of translation in the field, and there is much frustration in the public about the lack of an effective treatment. We critically reviewed past literature (1990–2014), analyzed numerous data, and discussed key issues at a consensus conference on Brain Ageing and Dementia to identify and overcome roadblocks in studies intended for translation. We highlight various factors that influence the translation of preclinical research and highlight specific preclinical strategies that have failed to demonstrate efficacy in clinical trials. The field has been hindered by the domination of the amyloid hypothesis in AD pathogenesis while the causative pathways in disease pathology are widely considered to be multifactorial. Understanding the causative events and mechanisms in the pathogenesis are equally important for translation. Greater efforts are necessary to fill in the gaps and overcome a variety of confounds in the generation, study design, testing, and evaluation of animal models and the application to future novel anti-dementia drug trials. A greater variety of potential disease mechanisms must be entertained to enhance progress.
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Many AD clinical trials that failed were successful in preclinical testing using animal models.
“the very high failure rate of clinical trials of AD therapeutics (of ~99.6%), many of which were successful in preclinical testing using these animal models [6, 27, 139]”
From Alzheimer's disease: experimental models and reality (2017) · cites this paper as [6]
The lack of additional AD-associated pathology could at least partly account for the lack of translation between preclinical and clinical trials.
“This lack of additional AD associated pathology could at least partly account for the lack of translation between preclinical and clinical trials [6], although there have also been a few clinical trial failures for approaches not initially tested in transgenic models[69].”
From Alzheimer's disease: experimental models and reality (2017) · cites this paper as [6]
The failure rate of clinical trials of AD therapeutics is approximately 99.6%.
“the very high failure rate of clinical trials of AD therapeutics (of ~99.6%), many of which were successful in preclinical testing using these animal models [6, 27, 139]”
From Alzheimer's disease: experimental models and reality (2017) · cites this paper as [6]
The very poor success rate of ~99.6% with AD targeting clinical trials can in part be explained by the premature translation of successful pathology reduction in transgenic mice to humans.
“The very poor success rate of ~99.6% with AD targeting clinical trials can in part be explained by the premature translation of successful pathology reduction in transgenic mice to humans [6, 27, 139].”
From Alzheimer's disease: experimental models and reality (2017) · cites this paper as [6]
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Alzheimer's disease: experimental models and reality
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Advance of sporadic Alzheimer's disease animal models
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Hargis, K. E., & Blalock, E. M. (2017) · Behavioural Brain Research · doi:10.1016/j.bbr.2016.05.007 · Cited by 90 · see citing works
- Authors
- Banik, A., Brown, R. E., Bamburg, J., Lahiri, D. K., Khurana, D., Friedland, R. P., Chen, W., Ding, Y., Mudher, A., Padjen, A. L., Mukaetova-Ladinska, E., Ihara, M., Srivastava, S., Padma Srivastava, M. V., Masters, C. L., Kalaria, R. N., & Anand, A.
- Affiliations
- Post Graduate Institute of Medical Education and Research (IN)
- Dalhousie University (CA)
- Colorado State University (US)
- Indiana University Indianapolis (US)
- University of Louisville (US)
- University of Pittsburgh (US)
- University of Southampton (GB)
- McGill University (CA)
- Institute of Neuroscience, Newcastle University, NIHR Biomedical Research Building, Campus for Ageing and Vitality, Newcastle upon Tyne, UK
- National Cerebral and Cardiovascular Center (JP)
- Central Drug Research Institute (IN)
- Department of Neurology, Neurosciences Centre, All India Institute of Medical Sciences, New Delhi, India
- Mental Health Research Institute (AU)
- Newcastle University (GB)
- Corresponding author
- Kalaria, Raj N.
- Anand, Akshay
- ORCID
- Venue
- Journal of Alzheimer’s Disease
- Publisher
- SAGE Publications
- Published
- 2015-08-11
- Volume
- 47
- Issue
- 4
- Pages
- 815-843
- ISSN
- 1387-2877 (ISSN-L)
- 1875-8908
- OpenAlex
- W2177793807
- Cited by
- 102
- References
- 267
- Citations by year
- 2026: 4 · 2025: 9 · 2024: 9 · 2023: 9 · 2022: 14 · 2021: 20 · 2020: 11 · 2019: 10 · 2018: 6 · 2017: 3 · 2016: 6 · 2015: 1
- FWCI
- 0.65
- Type
- journal article
- Language
- en
- Open access
- green
- doi.org
- Locations
- Journal of Alzheimer s Disease (publishedVersion)
- PubMed (publishedVersion)
- Newcastle University ePrints (Newcastle Univesity)
- Funders
- Japan Society for the Promotion of Science (15H04271)
- Topics
- Health Sciences › Medicine › Physiology › Alzheimer's disease research and treatments
- Health Sciences › Medicine › Psychiatry and Mental health › Dementia and Cognitive Impairment Research
- Life Sciences › Neuroscience › Neurology › Neurological Disease Mechanisms and Treatments
- Keywords
- Alzheimer's disease, translational research
- MeSH terms
- Alzheimer Disease, Animals, Clinical Trials as Topic, Humans, Translational Research, Biomedical
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
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