Lilly's Investigational AD Drug May Cause Brain Edema

Eli Lilly's investigational anti-amyloid drug for Alzheimer disease may (with emphasis on "may") be associated with vasogenic brain edema, just like Pfizer/JNJ's anti-amyloid compound in development. According to a Reuters report, Lilly's CEO said yesterday at the ongoing JP Morgan Healthcare Conference that 1 patient in a trial of solanezumab developed temorary brain swelling—although it's not clear if the patient is/was actually taking the investigational drug or placebo, because the trial remains blinded.

Last year, Lilly scrapped its clinical development of semagacestat, an anti-amyloid compound with a different mechanism of action, because semagacestat-treated patients actually faired worse than placebo-treated patients. Nevertheless Lilly's CEO is talking up the company's remaining investigational compound for AD...because that's what CEOs do.

Vasogenic brain edema has plagued the clinical development of bapineuzumab, another anti-amyloid mAb, which is in development by Pfizer/JNJ. It is speculated that the compound (at the highest dosage, anyway) promotes vascular leakage in the brain by attacking blood-vessel-associated amyloid. If that's the case, then it makes sense that any anti-amyloid compound would do the same.

mAb = monoclonal antibody.

Photograph: Atrophied brain from person with AD from National Institute on Alcohol Abuse and Alcoholism.