Welcome to r/science! This is a heavily moderated subreddit in order to keep the discussion on science. However, we recognize that many people want to discuss how they feel the research relates to their own personal lives, so to give people a space to do that, personal anecdotes are allowed as responses to this comment. Any anecdotal comments elsewhere in the discussion will be removed and our normal comment rules apply to all other comments.

I am a bot, and this action was performed automatically. Please contact the moderators of this subreddit if you have any questions or concerns.

Sadly, despite earlier reports of (slight) efficacy this study found that treatment with Tilavonemab wasn't significantly better than placebo.

>A total of 453 patients were randomized, of whom 337 were treated with tilavonemab (300 mg, n = 108; 1000 mg, n = 116; 2000 mg, n = 113) and 116 received placebo. Baseline demographics and disease characteristics were comparable across groups. The mean age was 71.3 (standard deviation [SD] 7.0) years, 51.7% were female, and 96.5% were White. At baseline, the mean CDR-SB score was 3.0 (1.2), which worsened through Week 96 for all treatment groups. The least squares mean change from baseline at Week 96 in the CDR-SB score with tilavonemab was not significantly different compared with placebo (300 mg [n = 85]: −0.07 [95% confidence interval (CI): –0.83 to 0.69]; 1000 mg [n = 91]: −0.06 [95% CI: –0.81 to 0.68]; 2000 mg [n = 81]: 0.16 [95% CI: –0.60 to 0.93]; all P ≥ 0.05). The incidence of any adverse event and MRI findings were generally comparable across groups.Tilavonemab was generally well tolerated but did not demonstrate efficacy in treating patients with early Alzheimer’s disease. Further investigations of tilavonemab in early Alzheimer’s disease are not warranted.

Why does this include the results for the three doses of tilavonemab, but not for the placebo group?

Three different amounts of the drug. As for placebo it would be 'hard' to devise 3 different amounts of nothing in solution. Maybe one could lie to the control group and tell them that they are getting different doses of the nothing solution. The article compares the effects to the placebo, hence the results are implicit in the design.

Zero surprise.

One thing strikes me. After the 50% price reduction in early 2022 the wholesale !! price of a one year 'maintenance dose' of Tilavonemab was $28,200. You can be sure that the company is still making money even after halving the price. As of April last year up to 1.5 million people had been treated with the drug. This is in the running for the most successful failure ever.

You don't have to dose placebo. You tell the participants there are either two or four conditions in a case like this. Most likely you've reveal the full design, that they will either receive a placebo or one of three doses of the drug. After that the participant and the researchers are blind as to what condition each participant is in. Until after the analysis is done.

You are not ethically allowed to lie to people and tell them they will receive medication when they might receive a placebo. They have to be aware that the possibility of placebo is there.

I know. The part about lying was deliberately facetious. Unless you get the ethics committee really drunk before the meeting of course. The question in the comment was phrased such that I couldn't say if the author meant 3 different doses of placebo or if they had missed the part where all the doses were compared to placebo. So I covered both bases with a little sugar pill of humour.

Oh I totally missed it :p

That’s nuts.

I can’t believe anyone prescribed dangerous placebos.

It’s hard to know what is more broken the FDA or Healthcare

Edit

> 1.5 million treated

No, 1.5 million would be eligible. CMS denied coverage to anyone who isn’t in a trial.

This is good news. I was hoping CMS would pass on this drug and they did.

I believe you are right and that I misread the NYT article.

[removed]

Why is CMS paying for trial drugs? I thought pharma companies paid for trials- isnt that their excuse for price gouging after the trial is done?

You’d think !

The trials will fail. All these new Alzheimer’s drugs are garbage.

By the time they figure out Alzheimer's I'll be an incontinent drooling vegetable. They've been spinning their wheels for 20 years, I swear.

Alot of it was based off of falsified data for literally decades that we just found out about

Nope, Cassava Sciences’ simufilam has been shown to improve cognition, behavior and a range of biomarkers in mild AD patients. Currently in Phase 3.

A quick google shows that several papers regarding this have been retracted and there are several investigations into potential fraud ongoing.

[removed]

Any promising ones?

Absolutely zero.

it’s all prevention:

Everything that’s good for the heart is good for the brain.

Stop eating sugar and seed oils.