Caught amid COVID-19, the organizers of this meeting decided on March 10, 2020, to switch to a virtual format. It offered prerecorded lectures and e-posters, as well as livestreamed discussions, “Meet-the-Professor” audio chats, and a virtual exhibit hall. New data included widely anticipated results of the DIAN-TU clinical trial of solanezumab and gantenerumab, and of robust phospho-tau plasma tests. The online stream also brought new data on a range of trials against tau, α-synuclein, and other targets in age-related neurodegenerative disease, and on pathogenesis and other topics.
A new meeting in the calendar, Tau2020, covered the biology and pathology of all tauopathies, both primary and secondary. Some of the 650 attendees saw it as an inflection point in tau research, getting researchers to think more broadly and bringing their collective knowledge to bear on a common problem. Highlights included a new staging scheme for tau progression in AD, new ligands for primary tauopathies, cryoEM structures for α-synuclein, and a receptor that facilitates spread of mutant tau in mouse models.
PET imaging is adding a new layer of understanding to scientists’ concept of Alzheimer’s disease pathogenesis and progression. At the 14th Human Amyloid Imaging conference, speakers detailed nuances in the relationship between plaques, tangles, and cognitive decline. They also described nascent efforts to tie pathology in specific brain regions to specific behavioral and cognitive symptoms. While HAI featured new data on the pros and cons of various tau tracers in development, the synaptic tracer UCB-J jumped to the fore. It appears to detect synapse loss throughout AD cortex, as well as in other neurodegenerative diseases such as frontotemporal dementia and progressive supranuclear palsy.
Following up on its October surprise, Biogen showed more data at the Clinical Trials in Alzheimer’s Disease conference, arguing that disparities in drug exposure explained the puzzlingly different outcomes in its one positive and one negative aborted Phase 3 trials. Audience members were put off by the messiness of the data set and not fully convinced by the analysis, but the majority said they believed the general signal that the antibody may slow disease progression. The prevailing mood was one of hopefulness, with most agreeing the results validate the amyloid hypothesis and suggest that effective treatments for AD are within reach.