From The Editor | December 17, 2012

Merck Goes Against Conventional Wisdom

By Rob Wright

I was recently reading a number of clinical trial news items, and a few got me thinking. Bristol-Myers Squibb recently killed its Alzheimer drug in development, while Merck continued to move forward with its candidate — MK-8931. There appears to be a movement underway to shift Alzheimer’s research to patients who are at earlier stages of the disease, which to me makes perfect sense — fix the problem before it gets any worse. Some find it interesting that Merck is testing their compound in a patient population which includes moderate cases. Some industry pundits are critical of Merck’s decision to test their compound on a patient population which includes moderate cases. Personally, I think that was a good decision by Merck.

Researching Alzheimer’s Is A Worthwhile Gamble

There are seven stages of Alzheimer’s, the first being no impairment, so really that leaves only six stages. The second stage is considered to be a very mild decline, and I would imagine very difficult to diagnose. Many people would probably chalk up some memory lapses as simple forgetfulness. Merck’s study is seeking 1,700 patients with mild-to-moderate Alzheimer’s, which are stages three and four of the onset of disease, fairly early if you ask me. There seems to be a push toward conducting Alzheimer’s research in the very early phases of the disease. This makes a lot of sense. Some seem to suggest that Merck shouldn’t be including moderate cases and should be striving to do the research even earlier. However, until every person has their genome mapped, I don’t know how much earlier Merck can realistically do so. Further, there may be additional insight to be gained by including moderate cases of this inherited genetic disorder, which ranks as the sixth leading cause of death among adults. Presently, Alzheimer’s afflicts 5.2 million Americans at an annual cost of $148 billion.

Going Against Conventional Wisdom

At the 2012 Bio International show, I met Philip Haydon, chair of neuroscience at Tufts University and president and cofounder of GliaCure. He introduced himself to me saying, “I think I found the cure for Alzheimer’s.” Now whether this turns out to be true or not, isn’t the point. The point is that Haydon, old enough to know better, went against conventional wisdom regarding his approach to researching Alzheimer’s. During my discussion with Haydon, we shared our doctoral program training experience of being told to stay close to the literature, and to building upon it when conducting research. Haydon agrees with me, that this conventional approach discourages folks from conducting research in areas where nothing had been done previously. When he decided to conduct his research, he resisted the temptation to play it safe, with regard to how he would be perceived by his peers, demonstrating a willingness to go against the conventional wisdom of established thinking, which he describes in the article – The Only Path To True Innovation In Drug Discovery. Conventional wisdom can be defined as ideas which have become so accepted that they go unquestioned. You have probably seen this in your office when an idea gets quashed with the – “We tried that before and it didn’t work.” Those that seem to be implying that simply because other companies have “been there, done that” in previous research, and therefore, it should never be revisited, may want to ponder, the benefits which have been gained from continued research on a 100 year old drug — aspirin.