Roche to Test Whether New Drug Can Prevent Alzheimer’s

(Bloomberg) — Roche Holding AG plans to test whether an experimental medicine can prevent Alzheimer’s disease symptoms in high-risk people, its latest investment in one of the most failure-prone areas of drugmaking. 

The new late-stage study will focus on people who are at risk of cognitive decline, Roche said in a statement late Sunday. The goal would be to slow down the emergence of symptoms, or prevent them entirely. 

Rivals Biogen Inc., Eli Lilly & Co. and Eisai Co. are already working in the presymptomatic Alzheimer’s field, according to Bloomberg Intelligence. Ultimately, companies aim to be able to use blood tests to identify people with abnormal buildup of protein linked to Alzheimer’s and to treat them before the disease progresses enough to be noticeable. 

The latest preclinical study is the third large, late-stage trial that Roche has announced for its drug trontinemab, which uses an experimental technology called brain shuttle to ferry medicine past the protective blood-brain barrier.

The compound is a newer version of gantenerumab, an earlier Roche drug that failed to slow cognitive decline. Another previous Roche drug also failed in a prevention study that recruited members of families in Colombia with a high likelihood of Alzheimer’s due to a gene mutation.  

“The major difference is going to be using a therapeutic that has transformative potential,” Levi Garraway, Roche’s chief medical officer, said Monday.

Like existing treatments including Lilly’s Kisunla and Leqembi, co-developed by Eisai and Biogen — and like Roche’s earlier failed drugs — the new compound is designed to clear the toxic amyloid protein from the brain.

Studies so far have shown the brain shuttle compound is able to clear large amounts of amyloid quickly, Garraway said, with low rates of the brain-bleed side effects linked to existing Alzheimer’s treatments. 

The Swiss drugmaker is also working on a diagnostic blood test for preclinical Alzheimer’s disease and expects it to be widely available while the studies are being run, Garraway said. 

Globally, about 315 million people may have preclinical Alzheimer’s, a European research team estimated in Alzheimer’s and Dementia journal in 2022. 

(Updates with Roche executive’s comments from the sixth paragraph.)

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