Understanding the Complexity and Heterogeneity of Alzheimer’s Disease: Thomas Wisniewski, MD

WATCHING TIME: 4 minutes

“Previously, most preclinical and clinical trials were very focused on amyloid. Almost all of them targeted beta-amyloid on the plaque side, but in recent years this has not been the case. Various targets are in progress. evaluation.”

From 1995 to 2021, $42.5 billion in cumulative private spending has funded clinical trials testing agents for Alzheimer’s disease (AD). At times, the field looked like it was on the verge of a breakthrough, with 57% of those costs coming from phase 3.1 trials nonetheless, aside from the approval of aducanumab in 2021 (Adehelm; Biogen) – which sparked controversy in the field of neurology and medicine as a whole – there have only been 5 new drugs, all for symptomatic treatment, to gain FDA approval in the last quarter century.

Over time, hundreds of articles have been published with the aim of better understanding the root causes of the disease and thus producing more diverse treatments. The complex nature of the disease and the diverse pathogenic pathways from which it derives make Alzheimer’s disease one of the most difficult diseases to resolve, said Thomas M. Wisniewski, MD. Wisniewski, director of the Alzheimer’s Disease Research Center and Center for Cognitive Neurology at NYU Langone, believes the community has gained an immense amount of knowledge about the pathology of the disease; however, finding effective therapies remains a challenge.

In an interview with NeurologyLive®, Wisniewski provided background on advances in understanding Alzheimer’s disease and the need to learn more about what drives the root of its pathology. Additionally, he discussed how drug development should be approached, the potential of combination approaches, and the challenges of finding drugs to treat the sporadic nature of the disease.

1. Cummings JL, Goldman DP, Simmons-Stern NR, Ponton E. The costs of developing treatments for Alzheimer’s disease: a retrospective exploration. Alzheimer’s dementia. Published online September 28, 2021. doi:10.1002/alz.12450

Sharon D. Cole