2023-05-05 11:18:17
In the case of Alzheimer’s disease, two types of lesions are involved: amyloid deposits and neurofibrillary degeneration. Each of these lesions is associated with a protein: β-amyloid peptide for the former, and tau protein for seconds.
Researchers working on this neurodegenerative pathology are still divided as to whether it is two distinct and associated phenomenaor if they are clearly related and that the accumulation of one begets the other. Still, these two proteins, beta-amyloid and tau, are the main tracks to try to find a way to cure this disease, if not to slow its progression.
A treatment that targets the beta-amyloid protein
The American pharmaceutical giant Lilly announced on Wednesday May 3, 2023 that it had obtained very encouraging results concerning the drug donanemab, which targets beta-amyloid, responsible for plaques of the same name in the brains of Alzheimer’s patients.
In a press release (Source 1), the laboratory indicates that it has completed a phase 3 clinical trialconducted among 1,182 Alzheimer’s patients.
After one year of treatment, 47 % of participants treated with donanemab showed no no worsening of the disease, thus suggesting that the molecule slows its progression. They were only 29% in this case in the placebo group, having received a drug which was not one, since it had no active ingredient.
Participants who received donanemab also showed a 36% reduction in cognitive decline, and a 40% reduction in the decline in their ability to perform certain daily tasks (driving, conversing, having hobbies or managing finances). Participants in the donanemab group also had their risk of disease progression to the next stage reduced by 39% compared to the placebo group.
The laboratory specifies that these same trends of slowing the progression of the disease were observed in 552 people with a more advanced stage, although it is likely that this new drug gives best results when taken in early stages of the disease.
Serious but rare side effects
The problem, if one had to be found, lies in the serious side effects that can occur as a result of this drug treatment. Drugs targeting beta-amyloid can indeed cause a condition called “amyloid-related imaging abnormalities” (ARIA). Two main types can be distinguished: those causing areas of temporary swelling (edema) in the brain, and those leading to cerebral microhemorrhages. In the donanemab treatment group as a whole, swelling occurred in 24% of participants. Bleeding occurred in 31.4% of participants in the donanemab group and 13.6% of participants in the placebo group. Two participants died direct consequences of these anomalies. However, the Lilly laboratory wants to be reassuring, stating that “majority of ARIA cases were mild to moderate and resolved or stabilized with appropriate support”.
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