Intended for healthcare professionals


Idalopirdine: another disappointment for people with dementia

BMJ 2018; 360 doi: (Published 21 February 2018) Cite this as: BMJ 2018;360:k753
  1. David G Le Couteur, professor of geriatric medicine1,
  2. Brace Bateman, living with dementia and dementia advocate2,
  3. Carol Brayne, professor of public health3
  1. 1Centre for Education and Research on Ageing, Concord Hospital and University of Sydney, Sydney, Australia
  2. 2Dementia Australia, Melbourne, Australia
  3. 3Cambridge Institute of Public Health, Cambridge, UK
  1. david.lecouteur{at}

This has already been a disheartening year for research into drug treatments for dementia and Alzheimer’s disease, especially for people affected by dementia. Negative results have been posted for phase III clinical trials of two 5-hydroxytryptamine-6 receptor (5-HT6) antagonists for the symptomatic treatment of moderate dementia,12 as well as for a trial of an amyloid β antibody as a disease modifying treatment in mild dementia.3 Pfizer announced that it will end its neuroscience and related dementia investments in drug development, removing a major industry partner from the field.4

Negative drug trials

These developments follow a long period of negative drug trials in dementia. In recent decades the failure rate has been nearly 100%,5 and the only registered medicines are the cholinesterase inhibitors and memantine, which at best generate modest symptomatic improvement in cognitive testing among some patients and for only a limited period.

Drug development has often been associated with great excitement generated by the so called breakthroughs seen in animal models of dementia, followed by uncertain results in early human studies and then the certainty of …

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