4 ms·

> A group of researchers mostly based at Columbia University are testing whether valacyclovir, an antiviral used against HSV1, can slow down cognitive decline i

> A group of researchers mostly based at Columbia University are testing whether valacyclovir, an antiviral used against HSV1, can slow down cognitive decline in people with early stage Alzheimer’s. Between 2018 and 2024, the researchers recruited 120 patients and treated half with the antiviral. Outsider view: while I'm excited we're making progress, I can't shake a feeling of sadness that the best we could manage was a study this small, started 7 years ago. If it's as pivotal as the article suggests, one would hope we could get more than 60 people in the experimental arm (IIUC this antiviral is widely prescribed, well-tolerated, and off-patent). Nonetheless, excited to see the outcome

epidemiology 2y ago
>If it's as pivotal as the article suggests Let's be honest, this is a longshot.
- onewheeltom 2y ago
  90% of drug trials fail. Shows you how primitive our accepted practice is. Where else is a 90% failure considered to be an acceptable outcome?
  - esperent 2y ago
    Ycombinator startups?
tim333 2y ago
Quite an interesting attempt to advance the general process is DeepMind's project to make a cell simulation so you can try chucking in drugs into the simulation and see what they would do quicker than in the lab/patients. They are talking about having a simple cell up in five years. Hassabis talking about it: https://youtu.be/CEOOMYxMvY4 https://youtu.be/CEOOMYxMvY4
bkfunk 2y ago
> off-patent Well there’s your problem: no one can make money off of it, unless they develop a new delivery mechanism, etc. Patents encourage developing new medicines, but not developing new knowledge about (never mind use of) old medicine. The solution (in the US) is obvious: federal funding of research that stands to help lots of people but not make lots of money. Since most of these patients (in the US) are going to be on Medicare, there could be huge potential cost savings to the taxpayer: memory care is EXPENSIVE, so even the paltry amount covered by Medicare racks up (and the opportunity costs of people paying for private memory care is enormous). But instead of increasing funding for this kind of life- AND MONEY-saving research, this administration is freezing and slashing research funding, and specifically targeting Columbia for political/Trump’s-petty-grudge reasons.
- absolutelastone 2y ago
  I suspect the lucrative patent system has helped create rather exorbitant costs and restrictions for performing trials, which hinders non-patentable research, ironically. But both the federal and state govts do fund tons of such research. Some states have specific Alzheimer's trials and funds. I would think they could handle dirt-cheap therapies like this without getting into sweeping political changes. Though I suspect the solution is much harder than just run a trial with the drugs we have, or else we would already be hearing about mountains of evidence from doctors using the medications off-label.
- alzamos 2y ago
  Worth mentioning that the evidence says that patents don't have an effect on new drug creation/inventions. Evidence is collected here http://www.dklevine.com/general/intellectual/againstfinal.htm http://www.dklevine.com/general/intellectual/againstfinal.ht..., pretty neat to know that Italy/Switzerland had a patentless pharma industry until quite recently. Having said that, I think you're right that under this system, research/capital definitely gets directed in a different way.
  - cyberax 2y ago
    This is bullshit. Drug research costs money, A LOT OF MONEY. A new drug right now costs somewhere around $5 billion, mostly because 90% of drugs fail in trials. mRNA vaccines, semaglutide, mAB therapies, none of these would have happened without patents as an incentive.
absolutelastone 2y ago
This article is all the supporting evidence without any of the setbacks and failures at reproducing the correlations. There have been attempts at showing benefits with antivirals before. Just not a full-on double-blind study apparently. I recall reading about a study with high doses that showed no benefit for people in early stages. The 7 years time duration probably comes from the size of the study and also how long it is believed to take to get benefit if there is one. I would think if it really worked they would have stopped early for ethics reasons because they should also give the treatment to the placebo arm rather than watch them decline while knowing how to prevent it.

epidemiology 2y ago

>If it's as pivotal as the article suggests Let's be honest, this is a longshot.

onewheeltom 2y ago
90% of drug trials fail. Shows you how primitive our accepted practice is. Where else is a 90% failure considered to be an acceptable outcome?
- esperent 2y ago
  Ycombinator startups?

tim333 2y ago

Quite an interesting attempt to advance the general process is DeepMind's project to make a cell simulation so you can try chucking in drugs into the simulation and see what they would do quicker than in the lab/patients. They are talking about having a simple cell up in five years. Hassabis talking about it: https://youtu.be/CEOOMYxMvY4 https://youtu.be/CEOOMYxMvY4

bkfunk 2y ago

> off-patent Well there’s your problem: no one can make money off of it, unless they develop a new delivery mechanism, etc. Patents encourage developing new medicines, but not developing new knowledge about (never mind use of) old medicine. The solution (in the US) is obvious: federal funding of research that stands to help lots of people but not make lots of money. Since most of these patients (in the US) are going to be on Medicare, there could be huge potential cost savings to the taxpayer: memory care is EXPENSIVE, so even the paltry amount covered by Medicare racks up (and the opportunity costs of people paying for private memory care is enormous). But instead of increasing funding for this kind of life- AND MONEY-saving research, this administration is freezing and slashing research funding, and specifically targeting Columbia for political/Trump’s-petty-grudge reasons.

absolutelastone 2y ago
I suspect the lucrative patent system has helped create rather exorbitant costs and restrictions for performing trials, which hinders non-patentable research, ironically. But both the federal and state govts do fund tons of such research. Some states have specific Alzheimer's trials and funds. I would think they could handle dirt-cheap therapies like this without getting into sweeping political changes. Though I suspect the solution is much harder than just run a trial with the drugs we have, or else we would already be hearing about mountains of evidence from doctors using the medications off-label.
alzamos 2y ago
Worth mentioning that the evidence says that patents don't have an effect on new drug creation/inventions. Evidence is collected here http://www.dklevine.com/general/intellectual/againstfinal.htm http://www.dklevine.com/general/intellectual/againstfinal.ht..., pretty neat to know that Italy/Switzerland had a patentless pharma industry until quite recently. Having said that, I think you're right that under this system, research/capital definitely gets directed in a different way.
- cyberax 2y ago
  This is bullshit. Drug research costs money, A LOT OF MONEY. A new drug right now costs somewhere around $5 billion, mostly because 90% of drugs fail in trials. mRNA vaccines, semaglutide, mAB therapies, none of these would have happened without patents as an incentive.

absolutelastone 2y ago

This article is all the supporting evidence without any of the setbacks and failures at reproducing the correlations. There have been attempts at showing benefits with antivirals before. Just not a full-on double-blind study apparently. I recall reading about a study with high doses that showed no benefit for people in early stages. The 7 years time duration probably comes from the size of the study and also how long it is believed to take to get benefit if there is one. I would think if it really worked they would have stopped early for ethics reasons because they should also give the treatment to the placebo arm rather than watch them decline while knowing how to prevent it.