PG98FD Amyloid protein in Alzheimer's disease (Shutterstock)

What­ev­er the FDA de­cides on ad­u­canum­ab, Alzheimer's re­search is fi­nal­ly, most­ly, kind of mov­ing be­yond the amy­loid hy­poth­e­sis

When Bio­gen an­nounced in March 2019 that their vaunt­ed Alzheimer’s drug ad­u­canum­ab failed two large late-stud­ies, Rachael Neve won­dered whether the field might fi­nal­ly move on.

For 30 years, Alzheimer’s re­search had been dom­i­nat­ed by a sin­gle the­o­ry: The amy­loid hy­poth­e­sis, or the idea that the dev­as­tat­ing con­di­tion could be traced to sticky plaques that build up in most pa­tients’ brains and that re­mov­ing those plaques of­fered the best path to­ward a cure. Neve, un­til she left the field in frus­tra­tion in 2008, served as one of a small co­terie of dis­si­dent sci­en­tists, who poked holes in the the­o­ry and de­vel­oped al­ter­na­tive hy­pothe­ses, even as they strug­gled for fund­ing and watched their pa­pers land in sec­ond-tier jour­nals.

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