Signals
22Frontotemporal dementia therapy programs reach late-stage trials
Progranulin-replacement therapy in GRN-mutation FTD, ASO programs in C9orf72 FTD-ALS, and tau-targeted programs are emerging in a previously bare category.
Dementia with Lewy bodies care formalises around alpha-synuclein-aware management
Cholinesterase inhibitor optimisation, antipsychotic-avoidance protocols, RBD recognition pathways, and emerging alpha-synuclein-targeted programs are reshaping DLB care.
CIDP therapy reshapes around FcRn antagonist class entry
Efgartigimod CIDP indication, follow-on FcRn antagonist programs, and structured maintenance protocols are reshaping chronic inflammatory demyelinating polyneuropathy management.
Chronic neuropathic pain therapy reshapes around novel sodium channel mechanisms
Suzetrigine (Nav1.8 inhibitor) acute pain approval and follow-on Nav1.8 and Nav1.7 programs in chronic pain are reshaping non-opioid pain management.
Restless legs syndrome therapy reshapes around augmentation avoidance
Alpha-2-delta ligand first-line preference, low-dose opioid use, and novel mechanism programs are restructuring restless legs syndrome management.
Post-stroke spasticity therapy options widen past oral baclofen
Botulinum toxin maturity, intrathecal baclofen pump access, and emerging novel mechanism programs are reshaping post-stroke spasticity management.
Stroke prevention restructures across atrial fibrillation, lipids, and acute window
Factor XIa inhibitors entering late-stage trials, expanded thrombectomy windows, and tenecteplase displacement of alteplase are restructuring stroke prevention and acute care.
Diabetic peripheral neuropathy therapy advances after a long quiet period
Capsaicin patch maturity, novel sodium channel modulators, and emerging disease-modifying programs are reshaping diabetic peripheral neuropathy management.
Genetically-targeted Parkinson's programs reach pivotal data
LRRK2 inhibitors and GBA-targeted programs in Parkinson's disease are reading out as the first genetically-defined Parkinson's therapy options.
Tardive dyskinesia therapy access patterns
Approved VMAT2 inhibitor therapy for tardive dyskinesia continues to expand but underdiagnosis remains the primary gap.
Donanemab's limited-duration treatment paradigm is reshaping the lifetime cost calculation against lecanemab
Donanemab's protocol stops dosing once amyloid clearance is achieved, typically 12-18 months. Lecanemab is continuous indefinitely. Over a 10-year treatment horizon, the implied lifetime cost difference is substantial.
ARIA monitoring infrastructure is the rate-limit on anti-amyloid uptake
Centres prescribing lecanemab and donanemab consistently report that MRI surveillance capacity, not patient demand or insurance approval, is the bottleneck on how many patients they can treat in 2026.
Gantenerumab post-mortem: what the failure tells the field about Abeta-targeting
The gantenerumab phase 3 readout failure is a useful data point for understanding what differentiates the successful anti-amyloid antibody class from the unsuccessful programs. The implications for next-generation amyloid-targeting and adjacent neurodegeneration pipeline are material.
Commercial payer coverage of anti-amyloid therapy is diverging from Medicare
Commercial payers are setting prior authorization and step-therapy criteria that meaningfully diverge from Medicare's coverage-with-evidence-development frame.
The "clinically meaningful" debate around CDR-SB is not settling
The interpretive argument over whether a sub-half-point CDR-SB delta represents a clinically meaningful slowing of decline continues to shape regulatory, payer, and clinician views.
NICE keeps the UK out of step with US and EU on anti-amyloid coverage
NICE's negative cost-effectiveness opinion on lecanemab and donanemab leaves the UK as a meaningful policy outlier, even after MHRA authorization.
Lecanemab uptake constrained by infusion infrastructure, not demand
Real-world rollout of lecanemab is gated by infusion-chair capacity and MRI monitoring schedules - not by patient interest or prescriber willingness.
Donanemab introduces a finite-duration treatment model
Donanemab's protocol allows treatment cessation once amyloid plaque clearance is confirmed - a meaningfully different model from indefinite biologic dosing.
APOE4 genotype is reshaping eligibility, dosing, and disclosure
Anti-amyloid trial readouts and post-marketing surveillance both show APOE4 homozygotes face higher ARIA risk - pushing genotype testing into pre-treatment workflows.
GLP-1 receptor agonists enter Alzheimer's clinical trials
Phase 3 readouts on semaglutide in Alzheimer's are due, with mechanistic interest in metabolic, vascular, and inflammatory pathways.
Subcutaneous anti-amyloid formulations move toward filing
Subcutaneous lecanemab data has been submitted to regulators; subcutaneous donanemab is in late development. Both reframe the access question.
Tau-targeting programs advance behind the amyloid wave
Anti-tau immunotherapies and small molecules are progressing through mid-stage trials, with the field watching for the first credible clinical signal.
Snapshots
10Dementia subtype therapy reference (2026)
Reference snapshot of dementia therapy across Alzheimer's, dementia with Lewy bodies, vascular, and frontotemporal subtypes.
Chronic inflammatory demyelinating polyneuropathy therapy reference (2026)
Reference snapshot of CIDP therapy across induction, maintenance, and emerging biologic tiers.
Spasticity therapy reference (2026)
Reference snapshot of spasticity therapy across post-stroke, multiple sclerosis, cerebral palsy, and spinal cord injury populations.
Acute ischemic stroke therapy reference (2026)
Reference snapshot of acute ischemic stroke therapy across thrombolysis and mechanical thrombectomy.
Migraine prevention therapy class reference (2026)
Reference snapshot of approved migraine prevention options including CGRP class, traditional preventives, and emerging mechanisms.
Anti-amyloid antibody landscape, 2026 mid-year reference
A dated reference snapshot of the anti-amyloid antibody class for Alzheimer's disease as of mid-2026: approved products, withdrawn products, late-stage pipeline, label-defining clinical evidence, and the operational pattern that defines the class.
DMD treatment landscape, 2026 mid-year reference
Reference layout of the Duchenne muscular dystrophy treatment landscape as of mid-2026: approved mechanisms across exon-skipping, gene therapy, and corticosteroid-class agents, late-stage pipeline, and the live commercial questions across patient populations.
Alzheimer's drug development pipeline, as of Q2 2026
A reference view of the late-stage Alzheimer's pipeline as of Q2 2026 - tau-directed programs, GLP-1 receptor agonists, neuroinflammation, synaptic and neuronal resilience, and genetic/protein-clearance approaches.
Payer coverage for anti-amyloid therapy, as of Q2 2026
A reference view of how anti-amyloid therapy is currently covered across US Medicare, Medicare Advantage, US commercial payers, and select international markets.
Disease-modifying therapies in Alzheimer's, as of Q2 2026
Two anti-amyloid antibodies have traditional FDA approval; subcutaneous formulations are advancing; the post-amyloid pipeline is portfolio-shaped.
Explained
15What is dementia with Lewy bodies?
Plain-language primer on dementia with Lewy bodies, why it is different from Alzheimer's, and how modern care works.
What is chronic inflammatory demyelinating polyneuropathy?
Plain-language primer on CIDP, why immune therapy is the foundation, and what the modern options can offer.
What is spasticity?
Plain-language primer on spasticity, why it happens after neurological injury, and what the therapy options can offer.
Acute ischemic stroke explained
Plain-language primer on acute ischemic stroke, why time matters, and how modern therapy works.
What ARIA is, and why it gates how anti-amyloid antibodies can be used
ARIA - amyloid-related imaging abnormalities - is the side effect that defines the operational and clinical experience of being on lecanemab or donanemab. Understanding what it is, who it affects more, and why it requires MRI surveillance is essential context for any conversation about anti-amyloid treatment.
What are GLP-1 receptor agonists, and why are they being tested in Alzheimer's?
GLP-1 receptor agonists are a class of drugs originally developed for type 2 diabetes and now widely used for obesity. The class is now in late-stage Alzheimer's trials. The mechanistic case spans metabolic, vascular, inflammatory, and direct neuronal pathways - and the access shape would be very different from anti-amyloid therapy.
What is a subcutaneous anti-amyloid antibody, and why does it matter for access?
Subcutaneous formulations of the anti-amyloid antibodies are reformulations that allow the same active drug to be given as a small under-the-skin injection rather than an intravenous infusion. The biology is the same. The delivery is dramatically simpler. The access implications are real but partial - subcutaneous administration removes the infusion-chair constraint, but does not change the MRI surveillance requirement.
What is iADRS, and how is it different from CDR-SB?
iADRS - the Integrated Alzheimer's Disease Rating Scale - is a composite endpoint that combines a cognitive score (ADAS-Cog) with a functional score (ADCS-iADL) into a single number. It is the primary endpoint donanemab used in its pivotal trial and is reported alongside CDR-SB in many late-stage Alzheimer's programs. It answers a slightly different question than CDR-SB does.
What is mild cognitive impairment, and how is it different from "early Alzheimer's"?
Mild cognitive impairment (MCI) is a diagnostic category, not a disease. It describes cognitive decline that is more than expected for age but not severe enough to count as dementia. When that decline is caused by underlying Alzheimer's pathology, the term you will increasingly hear in clinical-trial and treatment settings is "early Alzheimer's disease" - which means MCI due to Alzheimer's plus mild dementia due to Alzheimer's, taken together.
What is CDR-SB, and what does a small change on it actually mean?
CDR-SB is the Clinical Dementia Rating - Sum of Boxes, the cognitive and functional scale used as the primary endpoint in most late-stage Alzheimer's trials. It is a six-box, 0–18 scale, scored by a clinician from a structured interview with the patient and a caregiver.
What is Medicare coverage with evidence development?
Coverage with evidence development (CED) is a Medicare coverage mechanism that pays for a treatment on the condition that clinical data about its use is collected and reported back to CMS. It is how Medicare currently covers anti-amyloid antibodies.
What is ALZ-NET, and what does it do with patient data?
ALZ-NET is the Alzheimer's Network for Treatment and Diagnostics - the main patient registry collecting real-world data on people receiving anti-amyloid therapy in the US. It is the registry that Medicare's coverage-with-evidence-development framework routes patients through.
What are anti-amyloid antibodies, and how do they work?
A plain-language explanation of the disease-modifying drug class that defines the current Alzheimer's treatment landscape.
What is ARIA, and why does it matter for treatment?
Amyloid-related imaging abnormalities are the defining safety consideration of the anti-amyloid antibody class - and the reason MRI surveillance is built into treatment.
Why APOE4 matters in Alzheimer's disease and treatment
APOE4 is both the strongest common genetic risk factor for late-onset Alzheimer's and a meaningful modifier of treatment safety - which is why genotyping is now part of the workup.