As global pharmaceutical giants such as Johnson & Johnson (J&J) and Novo Nordisk face setbacks in developing Alzheimer’s treatments, Korean companies that have already progressed into clinical stages are drawing increased attention. With the Alzheimer’s treatment market rapidly expanding, Big Pharma’s struggles could create new openings for domestic biotechs. As a result, the clinical outcomes of these Korean companies may become decisive turning points.

According to industry sources on December 2, Novo Nordisk announced that its diabetes treatment Rybelsus (semaglutide) failed to slow the progression of Alzheimer’s disease in a two-year trial involving 3,800 patients with early-stage Alzheimer’s.

Rybelsus contains semaglutide, a GLP-1 receptor agonist. Previous preclinical and epidemiological data suggested that GLP-1 drugs might have potential benefits such as reducing brain inflammation and providing neuroprotection. Novo Nordisk evaluated these possibilities, but the attempt was unsuccessful. Detailed clinical data will be presented on December 3 at the Clinical Trials on Alzheimer’s Disease (CTAD) conference.

J&J also decided to halt clinical development of Posdinemab, an investigational antibody targeting tau protein, a key pathological driver of Alzheimer’s disease. Posdinemab had been considered a promising anti-tau antibody, but interim clinical results showed no benefit compared with placebo. Tau normally stabilizes microtubules in neurons; when tau becomes abnormally modified and accumulates—as seen in Alzheimer’s—neuronal damage occurs, leading to memory loss and cognitive decline.

As news spreads of repeated failures among major global players, expectations are rising that Korean companies could gain greater opportunities. Heo Hyemin, an analyst at Kiwoom Securities, noted:

“Following global pharmas’ clinical failures in Alzheimer’s drug programs, the development paths of remaining companies are being refined. Additionally, demand for alternative candidates to Big Pharma’s failed assets could increase technology-transfer opportunities for Korean biotechs.”

Among Korean developers, Oscotec is considered a leading contender. Like J&J, the company is developing an antibody drug (ADEL-Y01) that targets abnormal tau. ADEL-Y01 binds to pathologically altered tau in Alzheimer’s disease, preventing tau aggregation and spread, thereby protecting neurons.

Oscotec is currently conducting a Phase 1 clinical trial. Although both Oscotec and J&J target tau, Oscotec is viewed as having superior technology. An Oscotec representative explained:

“We are developing an antibody targeting the core region of acetylated tau (damaged tau). If the antibody does not bind to the core, it may detach along with the terminal regions. Our approach captures the core, which differentiates us from J&J’s development program.”

New-drug developer AriBio is advancing AR1001, an oral Alzheimer’s treatment candidate. Because the company is already conducting a global Phase 3 trial, it is expected to deliver the earliest results among Korean biotechs. AR1001 increases cerebral blood flow, protects neurons, and reduces inflammation. The U.S. Food and Drug Administration (FDA) approved its Phase 3 trial in Q4 2022. AriBio has also licensed the drug to Samjin Pharmaceutical in Korea, Neuco United in China, and Arcera Life Sciences in Latin America and the Middle East for development and commercialization.

D&D Pharmatech is developing NLY02, which targets degenerative brain disorders. In Alzheimer’s disease, brain immune cells become excessively activated; NLY02 suppresses this overactivation. The candidate is currently at the preclinical stage.

Meanwhile, interest is also growing in technologies that improve drug delivery to the brain. ABL Bio is not developing an Alzheimer’s drug itself, but it is advancing its BBB-shuttle platform Grabody-B, which enhances the delivery of Alzheimer’s therapeutic molecules across the blood–brain barrier. As late-stage clinical failures accumulate, demand is expected to rise for pairing already-approved drugs with BBB-shuttles to improve efficacy, reduce dosage, and minimize side effects. The Alzheimer’s-specific Grabody-B program remains in preclinical development.

Despite repeated clinical failures among domestic and global pharmaceutical companies, efforts to develop Alzheimer’s treatments continue because of the enormous potential of the global market. Although no single product currently holds a dominant share, successful market entry can lead to substantial growth amid accelerating population aging. Even lecanemab, one of the most prominent Alzheimer’s therapies, is estimated to hold only around a 5% market share.

Lecanemab, co-developed and co-commercialized by Japan’s Eisai and U.S. biotech Biogen, recorded approximately $200 million in sales last year, according to Eisai. Although estimates vary by research organization, the total Alzheimer’s treatment market was $3.6–4.2 billion in 2023 (₩5.3–6.1 trillion, roughly $3.6–4.2 billion), meaning each product’s relative share remains modest. Nevertheless, the overall market is projected to expand to $16 billion (₩23.5 trillion, approx. $16 billion) by 2030.

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