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Opinion: Aducanumab: the beginning of the end of Alzheimer’s disease?

The approval of aducanumab would help recast Alzheimer's disease. Because aducanumab isn't just a drug — it's also an idea. Just like the American Revolution and the shot heard 'round…
The Battle of Lexington marked the beginning of the American War of Independence, and inspired the line "the shot heard round the world" in Ralph Waldo Emerson's "Concord Hymn." Aducanumab may be that kind of "shot" for Alzheimer's disease.

In histories written about Alzheimer’s disease, 2019 will turn up as a landmark year, one in which researchers, clinicians, patients, and their families were whipsawed from crushing despair to giddy optimism.

The year unfolded with a string of disappointments. One of the biggest came on March 21 when Boston-based Biogen announced it had pulled the plug on two clinical trials of aducanumab, a promising treatment for individuals with Alzheimer’s disease. The drug had failed a “futility analysis,” meaning it would not be able to achieve its objectives. More bad news came in the weeks and months to follow. An entire class of drugs called BACE inhibitors (pronounced “base” as in baseball) had failed.

By the annual international meeting of Alzheimer’s investigators in Los Angeles in July, a pervasive disappointment was enmeshed with embarrassment,

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