If our readers do not belong to academic or pharmaceutical circles, they certainly think that rationality guides the choice of drugs tested in clinical trials. They also certainly think a drug is tested in a clinical trial only if pre-clinical works show a strong signal of efficacy in the targeted disease.
We live in a human, imperfect world, but sometimes it borders on stupidity. Let's discuss the case of memantine. It's a drug that has been known for 60 years. It was bizarrely applied to a large variety of mostly unrelated diseases, like diabetes, OCD, autism, depression, Parkinson's, and Alzheimer's diseases as well as COVID-19.
In all these cases it had consistently shown it was ineffective. If one is especially interested in ALS, it's interesting to note that there is no published preclinical work on memantine in ALS.
Yet there were 5 clinical trials of memantine in ALS!
The latest had just published its results/
Two of them were phase III clinical trials, the others were phase II, so it cost probably $50M overall.
What is behind this strange behavior? Are we so irrational as a species to make repetitively so impressively huge mistakes?
One layperson may be troubled to learn that in ALS only, there were more than 500 unsuccessful clinical trials.
Every week academics are claiming to have made breakthroughs in neurodegenerative diseases. Obviously, most if not all of these claims were wrong.
It seems that academic and pharmaceutical scientists are just throwing spaghetti at the wall to see if it sticks. Most of them are paid well at the end of the month for doing crappy work, so why bother working harder?
Jean-Pierre Le Rouzic (my email is at the bottom of the page)