[ed note: This is another installment from our favorite medical writer, Doc Gumshoe (no, he’s not a doctor, but we like the way he analyzes and explains medical issues for our readers).  Since he’s talking about specific companies this time, we’ve restricted the piece to the Irregulars and have inserted some comments about the stocks of the companies he mentions — Travis’ notes are in the beige boxes.  These are not stock picks from Michael or from us, just some interesting companies and trials to keep an eye on]

Since the last time I checked on this, about a year ago, the number of clinical studies in AD has increased from nearly 1,100 to nearly 1,300. Not all of these are drug trials. Some of them are assessing procedures, all the way from activities that may slow the progression of dementia in AD patients to whether the nurse practitioner telephones the patient every day. Quite a few have to do with means of detecting the disease at earlier stages – imaging techniques, or possible biomarkers. Some of the pharmaceutical agents being tested aim to stop or slow the underlying disease process, and these are usually based on a specific theory about what it is that causes the disease in the first place. And some of the drugs are essentially palliative – they don’t address the disease process, but they aim to help patients maintain their cognition, their memories, and their capacity to live relatively normally.

These trials are sponsored and conducted by a number of different kinds of entities. Most commonly, the trials are relatively small, Phase II trials, run and paid for by biotechs. But there are also trials sponsored by not-for-profits, by academic centers, by government, and, of course, by Big Pharma. There are currently 223 trials involving donepezil alone. Sometimes it is being used as a comparator, or as adjunctive treatment, and sometimes it is being investigated in particular classes of patients. I am not including clinical trials of established agents in this necessarily brief list. What I am doing is cherry-picking – searching for trials of agents that seek to attack AD through a different mechanism and that look promising.

Increasingly, new drug development is being led by the biotech sector. The big outfits have been concentrating on what they know how to do best – marketing their drugs. They look to the biotechs and the ...