The Clinical Trials Landscape for Alzheimer's Disease

Not only drug and non-drug development but also non-therapeutic research in Alzheimer's disease (AD) clinical trials is unclear.

The participants were AD clinical trials obtained from the clinicaltrials.gov registry. The research objectives and interventions of those trials were analyzed. Bibliometric network analysis of those published articles in PubMed was also conducted.

A total of 1681 clinical trials and 565 corresponding published articles in the past 20 years were included in the analysis. "Safety", "dose", "adverse events", and "biomarker" were the most frequently used words that appeared in the title or abstract of published articles. The top three classes of 362 drugs were anti-Amyloid, enhancing acetylcholine, neurotransmitter, or targeting its receptor. The physical therapy, diet, and cognitive training ranked as the first three classes of non-drug therapy. Imaging, risk factors, and molecular biomarkers were the three most abundant categories in non-therapeutic research, and three fields of prevention, risk factors, and the dental or intestinal microbiome showed an escalated trend (All P_trend < 0.05).

The results described a comprehensive landscape for the clinical studies of AD. Although most drugs treated AD abortively, the success of lecanemab and decanemab provides confidence for us to further study the pathogenesis of AD and explore new therapeutic targets to develop anti-AD drugs. Rising non-drug and non-therapeutic research will provide more possible methods for the treatment and prevention of AD in thefuture.