Christopher Viehbacher
Analyst
Yes. Thanks for the question. I don't think we really look at it that way. When -- I think the world changed with the CLARITY study. If we went back two years ago, three years ago, a lot of still doubt amongst the neurology community, does the amyloid beta hypothesis really hold water. There's been a huge debate within the community about whether that's a valid target or not. CLARITY, I think, really starts to put that debate to rest. And but the studies were done over -- in the case of CLARITY in an 18-month time frame. But actually, what we're seeing is that the world has moved on. Those 18 months, yes, we would dramatically reduce plaque and we actually see that there is a benefit in terms of slower cognitive decline. But that's not where it's going to end. In all likelihood, the way this is shaping up is that you're going to have at some point a plaque clearing phase. Then what happens after you've cleared the plaque? If you don't continue treating, the plaque is going to come back. So there's going to be, in all likelihood, a maintenance phase, that's where also the subcu formulation will be important. And then as we all know, MCI is not really early stage Alzheimer's. By the time you have MCI, by the time you have symptoms, you probably already have a maximum load of plaque. There are probably people on this call who are accumulating plaque in their brains as we speak and they don't know it. And by the time a certain amount of plaque has risen, then you've already had a certain amount of neuronal death. And right now, we don't know how to restore neurons. So there's also going to be, with the advance of blood diagnostics, but also even Eisai Biogen study ahead and looking at earlier patients, as one neurologist said, we're not looking at this any longer as a four to eight year disease, but we're looking at this over the time frame of a 25-year period. So if I look at donanemab finite, in some ways, it will be good if their data are positive, that it further reinforces the amyloid -- the beta amyloid hypothesis. And also there's -- we've always seen in new markets if there's more players that those markets develop faster. But this donanemab thought process of I'm just treating to a certain amount of plaque reduction. Most neurologists I talked to don't believe that fits anymore with the way we're thinking about the treatment of Alzheimer's. So I think it will be there, but I think it's going to be -- it's not really going to be adopted in the same way that people thought when that study was conceived. So let's say, I think, it will be good if there's other players in the market. But I don't think we are too concerned about competing with donanemab.