In the 1940s, the synthesis of alkaloids revived pharmacology and led to the belief that all symptoms and diseases could be circumvented. These drugs are still very numerous, but their commercial virtue has long since exceeded their therapeutic effectiveness.
Today, the craze is for the monoclonal antibodies developed from the 1980s. They are very numerous, and they can be recognized by their international common name which always ends in “mab” (Monoclonal AntiBody). They were initially proposed in oncology with some sporadic results of low health profitability. They were logically tested in infectiology and Covid19 gave them great visibility despite their clinical mediocrity.
Despite this difficult gap to bridge between theoretical hope and harsh clinical reality, let’s remain positive and encourage research around these “mabs”. Alas, they are now offered in the most eccentric indications with a coarseness of which only the trade is capable.
Aducanumab was proposed in 2021 to treat Alzheimer’s disease with great publicity and the customary complicity of the media. The principle was of a stupidity that leaves you speechless, consisting in destroying the beta amyloid proteins which accumulate in the cortex, and of which we do not know whether they are the cause or the consequence of the disease, or even corollaries of senescence. Faced with its exorbitant cost for a negative benefit/risk ratio, the drug was either withdrawn or refused by most ministries.
But manufacturers are tenacious, and as no one has found more attractive than these amyloid plaques to seduce doctors and obtain approval from the authorities, they have just proposed a new “mab”, lecanemab. Thanks to a publication in the NEJM (New England Journal of Medicine) which is the tabloid of the pharmaceutical industry, they hope to obtain an authorization, especially in prevention, because the clientele anxious at the slightest loss of memory is immense. It would be enough to hold out a year before the evidence of its clinical ineffectiveness to have a comfortable return on investment.
The challenge is there: to last long enough. But it appears that the market, in addition to being crude, is almost ridiculous. Indeed, to date, no drug (mab or other) proposed in Alzheimer’s disease has had a positive benefit/risk ratio, and we can safely say that this degeneration intimately linked to age will never experience therapeutic revolution.
We still have to hope for the miracle of a mab for myopathy or infantile leukemia. I want to believe it. In the meantime, I propose to consider researchers involved in therapeutic research on Alzheimer’s disease as having a priori conflicts of interest. And I’m sure it doesn’t take much scratching to prove it.