Viewing a single comment thread. View all comments

zeddoh t1_iycn8ib wrote

Reply to comment by Relevant_Quantity_49 in Alzheimer's drug lecanemab hailed as momentous breakthrough by Methoszs

I do agree with you re headlines. But a few years ago, I started working with researchers and specifically Alzheimer’s researchers (not in a sciencey role at all). It has been such a long slog and there have been so many failures that the simple fact that there is now proof we can modify this disease really is momentous. Medical research is such a long game, especially Alzheimer’s research, which is chronically underfunded.

This quote from a recent article struck me:

“Earlier this year, De Strooper searched the US medical database PubMed for dementia. He found 250,000 studies. He then searched for cancer and found 4.7m. Next, he searched for Covid, a disease that didn’t exist before 2019, and found 300,000 studies. It’s a rough metric, but it suggests that more research has been done on Covid in the past three years than on dementia in the past century.”

Edit - I am very sorry you are having to watch a loved one go through AD, it is truly such a cruel disease.

18

Relevant_Quantity_49 t1_iycsbqv wrote

The effect this study found is so small it could very well evaporate in follow-up studies. It's not proof we can modify Alzheimer's at all. At best it's an indication of an avenue for further research. That's my point: We're celebrating before we're certain there's anything to celebrate.

Regarding the difference between dementia research and the novel coronavirus, we need to keep in mind that they are not remotely equivalent situations.

First, they don't have equivalent economic or social impacts. SARS-CoV-2 is killing and disabling far more people and wreaking havoc on global economic systems. Dementia is not.

Second, their research involves different levels of complexity. Identifying and developing treatments for a novel virus is a lot more straightforward (relatively speaking) than unlocking the secrets of the brain. Neuroscience on a whole is a field that is a slow slog.

Third, the research is occurring on different scales. Alzheimer's was first described in 1906, when scientific publishing was still quite young. All of the basic research, case studies, and clinical reports happened when there were very few places to publish, very few researchers, and there wasn't a ton of research specialization.

Covid, on the other hand, came along at what may be the height of academic publishing. There are tons of journals on every conceivable specialty--more than a few of dubious quality--and a "publish or perish" mindset that drives people to put anything out there whether or not it's decent work. Additionally, the medical research and scientific field is huge compared to what it was with specialists for everything you can think of.

And Covid, because of it's unique behavior as a virus that affects pretty much every organ system, touched all of those specialties simultaneously.

Instead of the basic research trickling out in the pages of The Lancet over months or years because that is how science worked in the early 20th century, everyone and his cousin published their observations and experiments at roughly the same time.

As horrifying as Covid was, watching the research explode virtually overnight was incredible. But, yeah, while Alzheimer's research is definitely underfunded, one can't draw any meaningful conclusions from a comparison with Covid research.

13

zeddoh t1_iycvoc8 wrote

I’m going off what the head of research at the Alzheimer’s Society has said. Are you saying he’s wrong? Not trying to be combative - genuinely wondering.

““This is not a cure by any stretch of the imagination, but if it does slow cognitive decline, it means that for the first time we are modifying the disease,” says Dr Richard Oakley, head of research at the Alzheimer’s Society.”” From here

Appreciate your analysis of the covid / Alzheimer’s research comparison, really interesting insights. Totally agree the explosion of Covid research was incredible to behold!

3

Relevant_Quantity_49 t1_iycxp6m wrote

I'm saying he's premature. We aren't going to know if he's right or wrong until we see additional studies. This is how science works.

I think it's important to remember that professionals are just as prone to confusing what they want to be true with what is true as anyone else. When someone's entire career is oriented towards a certain goal, they're representative of an organization oriented towards a certain goal, and they're speaking to a reporter, I think that line can become even more blurry.

If you look at the entire quote, Oakley isn't even basing his statement in the research itself. He's basing it on what nebulous "people" and "everyone" are saying.

>“This is not a cure by any stretch of the imagination, but if it does slow cognitive decline, it means that for the first time we are modifying the disease,” says Dr Richard Oakley, head of research at the Alzheimer’s Society. “We need to understand the real-world clinical benefit, but I’ve spoken to people and where there’s never been excitement, always hesitation, this does look like the real deal. We need to see the data, but everyone is now saying this is the beginning of disease-modifying treatments.”

If you have a strong study, you don't talk about how other people are telling you how exciting the study is. You talk about how exciting the study is. Furthermore, anywhere in that statement that he talks about the research, he talks about uncertainty. "We need to understand the real world clinical benefit, but..." meaning the study doesn't show that. "We need to see the data, but..." meaning it's not there yet.

If it was there, he would've said "The study shows..." or "The data shows..."

6

zeddoh t1_iyd4ibl wrote

Thanks for taking the time to explain. That article and the quotes were actually from a couple of weeks ago, before the full results of the study were released just yesterday (initially the drug company just released a summary statement), so he wouldn’t have been able to say ‘the study/data shows’ but I do take your point more broadly.

There are so many respected, expert scientists in this field (representing numerous organisations and institutions all over the world, not affiliated with the drug company) stating this is an exciting step forward and I believe them. More fool me perhaps. They aren’t saying it’s a magic pill, they’re saying it’s the start, while also rightly highlighting the numerous real issues now to be tackled through further investigation, additional studies, etc. That’s how science works, as you say. What happens next will be the proof in the pudding.

3