Alzheimer’s Treatment Controversy, Science Mistakes, Chonky Fish. June 11, 2020, Part 2

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FDA’s Approval Of Debated Alzheimer’s Treatment Raises Controversy

This week, the FDA gave the green light to a drug for the treatment of Alzheimer’s disease. The drug, a monoclonal antibody called aducanumab, is the first Alzheimer’s treatment to receive approval in almost 20 years. It targets the amyloid protein that forms the tangled plaques found in the brains of people with Alzheimer’s. But while researchers agree that aducanumab leads to less amyloid plaque, no one really knows what that means in terms of real benefits for people with the disease.

Researchers still don’t understand the role of amyloid in the progression of Alzheimer’s disease—and in two studies conducted by the company Biogen, only one showed taking aducanumab provided a slight cognitive benefit to people with early Alzheimer’s. The other study showed no effect compared to a placebo. However, the FDA elected to ignore the recommendations of an outside advisory panel, and approved the medication under an accelerated approval process. The drugmaker will be required to conduct additional testing on the treatment while it is on the market, and the FDA has the option to rescind approval if a Phase 4 trial fails to show efficacy.

Biogen will sell the treatment under the trade name Aduhelm, at a list price of around $56,000 per year—not including the extensive office visits, tests, brain scans, and monitoring that will go along with the course of treatment. Pam Belluck, a writer covering science and medicine for the New York Times, joins host John Dankosky to explain the decision, and how the drug might fit into the larger picture of Alzheimer’s research.

When Scientists Get It Wrong

A couple of years ago, Julia Strand was trying and failing to replicate a study she’d published. At the time, she was an assistant professor without tenure, and the original study had presented her most exciting finding to date. But when she and her co-authors tried to replicate it, they got the opposite results. Then one night, Julia discovered why. In her original code, she’d made a tiny but critical error, and now, with her reputation and job on the line, she was going to have to tell the world about it.

Science is often said to be “self-correcting”—through peer review, replication, and community dialogue, scientists collectively find mistakes in their work, and continually revise their understanding of the world. But what does self-correction look like in practice? And how likely are scientists to admit they’re wrong?

Julia eventually submitted her story to the Loss of Confidence Project, which invited psychologists to publicly admit mistakes in their published research. Our guest, Julia Roher, a lecturer in psychology, organized the project, along with two others. In an anonymous survey of 316 researchers, almost half said they had lost confidence in one of their findings, but ultimately, only 13 researchers submitted public testimonials to the project.

Brian Resnick, who co-created Vox’s Unexplainable podcast and has written about intellectual humility, explains why we often think we’re right when we’re wrong, how others perceive us when we fess up to mistakes, and what all this means for our trust in science.

Charismatic Creature Corner: Chonky Fish Edition

In South Africa in 1938, a young museum curator named Marjorie Courtenay-Latimer was performing one of her regular duties when she saw something incredible. Courtenay-Latimer was tasked with inspecting fish brought in by local fishermen that were considered out of place in the region. That’s how she found what she later called the most beautiful fish she had ever seen: a coelacanth, thought to be long extinct.

Courtenay-Latimer’s discovery did not immediately register as a coelacanth, because the creature was thought to have gone extinct at the end of the Cretaceous period, 66 millions years ago. The fish was seen as a modern Lazarus—a mysterious creature brought back from the dead, stumping scientists.

At six feet long and 200 pounds, some consider the coelacanth to be a big, beautiful fish. According to Dr. Prosanta Chakrabarty, professor and curator of fishes at Louisiana State University, the coelacanth is the meathead of the sea.

“They are chunky,” Chakrabarty said. “You can hold their fin and it feels like you’re shaking somebody’s hand.”

Because they’re so old, coelacanths are closer to the human genealogical lineage than they are to any modern fish. But because this is the Charismatic Creature Corner, only one thing really matters: Is it charismatic enough to enter the Charismatic Creature Corner Hall of Fame?

Joining guest-host John Dankosky to argue for the coelacanth entering the Charismatic Creature Corner Hall of Fame is SciFri producer Kathleen Davis and Dr. Chakrabarty.

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