Sign up for our daily briefing

Make your busy days simpler with the Axios AM and PM newsletters. Catch up on what's new and why it matters in just 5 minutes.

Please enter a valid email.

Please enter a valid email.

Subscription failed
Thank you for subscribing!

Catch up on the day's biggest business stories

Subscribe to the Axios Closer newsletter for insights into the day’s business news and trends and why they matter.

Please enter a valid email.

Please enter a valid email.

Subscription failed
Thank you for subscribing!

Sign up for Axios Pro Rata

Dive into the world of dealmakers across VC, PE and M&A with Axios Pro Rata. Delivered daily to your inbox by Dan Primack and Kia Kokalitcheva.

Please enter a valid email.

Please enter a valid email.

Subscription failed
Thank you for subscribing!

Sports news worthy of your time

Binge on the stats and stories that drive the sports world with the Axios Sports newsletter. Sign up for free.

Please enter a valid email.

Please enter a valid email.

Subscription failed
Thank you for subscribing!

Tech news worthy of your time

Get our smart take on technology from the Valley and D.C. with Axios Login. Sign up for free.

Please enter a valid email.

Please enter a valid email.

Subscription failed
Thank you for subscribing!

Get the inside stories

Get an insider's guide to the new White House with Axios Sneak Peek. Sign up for free.

Please enter a valid email.

Please enter a valid email.

Subscription failed
Thank you for subscribing!

Catch up on coronavirus stories and special reports, curated by Mike Allen everyday

Catch up on coronavirus stories and special reports, curated by Mike Allen everyday

Please enter a valid email.

Please enter a valid email.

Subscription failed
Thank you for subscribing!

Want a daily digest of the top Denver news?

Get a daily digest of the most important stories affecting your hometown with Axios Denver

Please enter a valid email.

Please enter a valid email.

Subscription failed
Thank you for subscribing!

Want a daily digest of the top Des Moines news?

Get a daily digest of the most important stories affecting your hometown with the Axios Des Moines newsletter.

Please enter a valid email.

Please enter a valid email.

Subscription failed
Thank you for subscribing!

Want a daily digest of the top Twin Cities news?

Get a daily digest of the most important stories affecting your hometown with Axios Twin Cities

Please enter a valid email.

Please enter a valid email.

Subscription failed
Thank you for subscribing!

Want a daily digest of the top Tampa Bay news?

Get a daily digest of the most important stories affecting your hometown with the Axios Tampa Bay newsletter.

Please enter a valid email.

Please enter a valid email.

Subscription failed
Thank you for subscribing!

Want a daily digest of the top Charlotte news?

Get a daily digest of the most important stories affecting your hometown with Axios Charlotte

Please enter a valid email.

Please enter a valid email.

Subscription failed
Thank you for subscribing!

Want a daily digest of the top Nashville news?

Get a daily digest of the most important stories affecting your hometown with the Axios Nashville newsletter.

Please enter a valid email.

Please enter a valid email.

Subscription failed
Thank you for subscribing!

Want a daily digest of the top Columbus news?

Get a daily digest of the most important stories affecting your hometown with the Axios Columbus newsletter.

Please enter a valid email.

Please enter a valid email.

Subscription failed
Thank you for subscribing!

Want a daily digest of the top Dallas news?

Get a daily digest of the most important stories affecting your hometown with the Axios Dallas newsletter.

Please enter a valid email.

Please enter a valid email.

Subscription failed
Thank you for subscribing!

Want a daily digest of the top Austin news?

Get a daily digest of the most important stories affecting your hometown with the Axios Austin newsletter.

Please enter a valid email.

Please enter a valid email.

Subscription failed
Thank you for subscribing!

Want a daily digest of the top Atlanta news?

Get a daily digest of the most important stories affecting your hometown with the Axios Atlanta newsletter.

Please enter a valid email.

Please enter a valid email.

Subscription failed
Thank you for subscribing!

Want a daily digest of the top Philadelphia news?

Get a daily digest of the most important stories affecting your hometown with the Axios Philadelphia newsletter.

Please enter a valid email.

Please enter a valid email.

Subscription failed
Thank you for subscribing!

Want a daily digest of the top Chicago news?

Get a daily digest of the most important stories affecting your hometown with the Axios Chicago newsletter.

Please enter a valid email.

Please enter a valid email.

Subscription failed
Thank you for subscribing!

Sign up for Axios NW Arkansas

Stay up-to-date on the most important and interesting stories affecting NW Arkansas, authored by local reporters

Please enter a valid email.

Please enter a valid email.

Subscription failed
Thank you for subscribing!

Want a daily digest of the top DC news?

Get a daily digest of the most important stories affecting your hometown with the Axios DC newsletter.

Please enter a valid email.

Please enter a valid email.

Subscription failed
Thank you for subscribing!

Please enter a valid email.

Please enter a valid email.

Subscription failed
Thank you for subscribing!
Expand chart
Adapted from a PhRMA analysis of the Adis R&D Insight database on investigational drugs in various stages of clinical development; Chart: Axios Visuals

Gradually losing memories in a tangle of errant proteins and dying brain neurons from Alzheimer's disease strikes fear into many. Time after time, drug companies have struck out in trials looking to prevent or even slow the debilitating disease and are turning to fundamentally different approaches, or altogether abandoning their efforts.

Why it matters: There are currently 5.7 million Americans living with the disease — and 14 million more are expected to develop it by 2050 — all of whom are desperately seeking answers.

The big picture: There are roughly 326 active, recruiting or enrolling by invitation clinical trials on the elusive disease, per clinicaltrial.gov. The U.S. last year dramatically stepped up funding for Alzheimer's disease research, from $400 million a year to over $2 billion annually, although the Alzheimer's Association says more is needed.

The biggest problem: Scientists still don't know the cause of Alzheimer's.

  • There's a strong genetic link in the rare early-onset type (in those under 65 years) but the cause is less clear for the majority of those with Alzheimer's who are older than 65.
  • What is known: More women (2/3) than men get the disease, there are genetic risk factors, and there are 3 hallmarks — brains show increased beta-amyloid proteins leading to "plaques," there are large numbers of tau protein creating "tangles," and neurons are lost accompanied by brain-size shrinkage.

For decades, the buzz centered on those proteins, with the hope that at least one is a cause of the disease and not just caused by it — but so far none have panned out, resulting in an expensive array of halted experiments with a recent shift toward other research areas.

  • According to PhRMA (and indicated in the chart above based on an Adis database), 146 investigational drugs were halted in development and 4 were approved from 1998–2017.
  • For the discontinued trials, 40% were in early trial phases 0, 1, or 1/2; 39% in phases 2 or 2/3; and 18% had made it to phase 3 or regulatory review before being dropped, PhRMA reported.
  • The 4 that were successfully approved (Aricept, Exelon, Razadyne and Namenda) during that period all aim to lessen symptoms, like memory loss and confusion, but do not halt or slow the progress of the disease.

The latest: Here are some of the approaches now, some of which target more than one goal...

  • Staying the amyloid course: Some companies continue looking at anti-amyloid drugs, such as this phase 3 trial of BAN2401 that focuses on people with mild Alzheimer's disease or this phase 3 trial of AMG 520/CNP520 that inhibits the BACE1 enzyme that helps form plaque.
  • Examining other possible causes: Derek Lowe, a chemist who works on drug discovery and writes the blog "In the Pipeline," tells Axios he's intrigued by recent trials looking at the possible role of viruses or bacteria in setting off the disease, though he calls it "a long shot."
  • Slowing its progression: Some trials are looking to help save people's memories and slow the degeneration caused by the disease, including this phase 2 trial of PDE4D.
  • Treating its conditions: Therapies to treat some of the conditions of Alzheimer's, such as these two trials (for AXS-05 and AVP-786) try to help with agitation.
  • Finding it earlier: Diagnostics, including imaging and blood tests, are a growing field. "Let's see if we can predict the onset of Alzheimer's," NIH director Francis Collins told a press briefing last week, saying he hoped the long-term study of 1 million people in the All of Us program could assist.

New avenues aren't just in medicine and genetics but on the impact from lifestyle changes including reproductive health with its changes in the vascular and immune systems, and modifiable risk factors like sleep, cardiovascular disease and blood pressure.

  • "We're still learning more and more about what the biological changes mean and how they relate to changes in cognitive [behavior] over time," Rebecca Edelmayer, director of scientific engagement of the Alzheimer's Association, tells Axios.
  • Earlier this week, the World Health Organization issued guidelines for every day life to reduce the risk of dementia.

Go deeper:

Go deeper

Updated 31 mins ago - World

Ukraine crisis: Blinken to visit Kyiv, then meet Russian foreign minister

Photo: Russian Foreign Ministry/Handout/Anadolu Agency via Getty Images

Secretary of State Antony Blinken will meet with Russian Foreign Minister Sergey Lavrov in Geneva on Friday, following a trip to Kyiv to reinforce U.S. support for Ukraine in the face of a possible Russian invasion, according to a senior U.S. official.

Why it matters: The meeting with Lavrov suggests a diplomatic resolution to the crisis may still be on the table, despite the collapse of security talks between Russia and the West last week.

Updated 1 hour ago - Politics & Policy

Omicron dashboard

Illustration: Brendan Lynch/Axios

  1. Health: Transplants rebound from COVID lull — CDC director says COVID-19 messaging should have been clearer — Concerns grow over CDC's isolation guidelines.
  2. Vaccines: Kids' COVID vaccination rates are particularly low in rural America — America's vaccination drive runs out of gas.
  3. Politics: Joint Chiefs chair Gen. Mark Milley tests positive for COVID-19 — Vivek Murthy calls SCOTUS vaccine mandate block "a setback for public health."
  4. States: America struggles to keep schools open — Youngkin ends mandates for masks in schools and COVID vaccinations for state workers.
  5. World: Greece imposes vaccine mandate for people 60 and older — French parliament passes COVID vaccine passport legislation.
  6. Variant tracker

Mayors feel powerless to reduce homelessness

Expand chart
Recreated from 2021 Menino Survey of Mayors; Chart: Jacque Schrag/Axios

America's mayors know their constituents hold them accountable for homelessness, but many don't feel they have the tools or power to fix things, a brand new survey says.

Why it matters: While homelessness has become more acute during the pandemic, city leaders say they lack the money, staff or political support needed to make a meaningful difference.