STAT Plus: AC Immune bets that its Alzheimer’s trial design could provide a cleaner test of the amyloid hypothesis

The fate of aducanumab, a potential Alzheimer’s treatment from Biogen, is widely seen as the last hope for an aging idea: that targeting toxic brain plaques can arrest the progress of the disease.

But there’s a similar, less-discussed Alzheimer’s treatment working through a pivotal trial. And its outcome, positive or negative, could shift the yearslong debate over how best to target Alzheimer’s. The drug is crenezumab, and like Biogen’s treatment, it’s meant to bind to beta-amyloid plaques in the brains of patients with Alzheimer’s. But AC Immune, the company behind crenezumab, is taking a novel approach to testing its worth. Instead of casting a wide clinical net for people with Alzheimer’s symptoms, the company has recruited only patients with a rare genetic mutation that almost guarantees they will develop the disease — and will treat them before any signs of dementia emerge. The study, conducted in Colombia, is expected to generate data in early 2022.

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