Lilly's Solanezumab Fails In Alzheimer's Prevention Trial

Eli Lilly and Co. (LLY), in an update on A4 Study of Solanezumab for preclinical Alzheimer's Disease, said Wednesday that the drug did not slow the progression of cognitive decline due to Alzheimer's disease (AD) pathology when initiated in individuals with amyloid plaque but no clinical symptoms of the disease, known as the preclinical stage of AD1.

Solanezumab only targets soluble amyloid beta. The treatment did not clear plaque or halt accumulation of amyloid in participants treated with the drug in the Anti-Amyloid Treatment in Asymptomatic Alzheimer's disease (A4) Study.

The A4 Study, which started in 2013, was a first-of-its-kind secondary prevention trial, enrolling more than 1,100 individuals between 65 and 85 years of age who had PET-imaging evidence of amyloid plaque accumulation in the brain and who did not have clinical impairment. Participants were randomized to either solanezumab or placebo and then treated for approximately 4.5 years.

The company noted that results of the A4 Study clearly showed that the primary and secondary endpoints were not met. Therefore, the study concluded its clinical development of solanezumab and indicated that targeting soluble amyloid beta through the mechanism is not effective in the population.

According to the company, Solanezumab binds only to soluble amyloid-beta protein and was not expected to significantly remove deposited amyloid plaques. Donanemab and remternetug, other Lilly investigational antibodies currently being developed in Phase 3, are different from solanezumab in that they specifically target deposited amyloid plaque and have been shown to lead to plaque clearance in treated patients.

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