2023-11-02 11:34:00
Alzheimer’s cannot be cured. But now new therapies are regarding to be approved. Antibodies have been proven to cause amyloid plaques in the brain to disappear. This can slow the progression of the disease, but cannot reverse it. However, in combination with early diagnosis, symptoms can be effectively stopped, says Prof. Dr. Dorothee Saur, neurologist at Leipzig University Hospital. In the interview she gives answers to what the development means for patients.
Question: Many people fear dementia in old age. Applications are currently being submitted to the European Medicines Agency (EMA) for approval of two new drugs that are intended to combat memory loss. One of them has already been approved in the USA. What does this mean for Alzheimer’s treatment?
Prof. Saur: This is a real milestone; we have been waiting for this for a long time. To date, we do not have any effective therapies to influence the process of cognitive decline that occurs in dementia. The two therapies that are now regarding to be approved are aimed at precisely this – they slow down the loss of brain and memory performance. This happens when the administered antibodies stimulate the immune system so that it attacks and disposes of the existing amyloid deposits in the brain, the plaques. This can be easily understood with special PET brain scans – existing deposits disappear almost completely. However, this has not yet stopped the progression of the disease, just slowed it down significantly. But this makes a big difference for those affected: This might mean additional years of life with fewer restrictions.
Does this apply to all Alzheimer’s sufferers, or are there restrictions?
Prof. Saur: It opens up completely new possibilities for us, especially for people with a very early stage of dementia. Thanks to modern diagnostic methods, we can now identify very precisely whether an early form of Alzheimer’s disease is present. Those affected do not notice much of the illness in everyday life and may have very slight cognitive disorders, but these are of no further consequence. However, we can already see using PET scans or cerebrospinal fluid diagnostics that the disease process has already begun. With the new means we can start treatment in this phase and slow the progression by up to 30 percent. This is a real advantage for patients, as their brain functions, which are still largely intact, may not deteriorate so quickly. The effect would therefore be greatest for this group, so we assume that the therapies will be approved for early disease progression, even if the approval criteria are currently still open.
When do you expect the therapies to arrive at the clinic?
Prof. Saur: We expect this in Germany in early summer 2024. And then we need the appropriate prerequisites for the very complex therapies: imaging and cerebrospinal fluid testing for early diagnostics and therapy places. On the one hand, the infusions involved, which last several hours, must be administered regularly at intervals of two to four weeks. We are talking regarding a treatment that will last several months, although the exact duration is not yet known. The patients must be well cared for during this time, with regular MRI examinations to monitor progress, especially at the beginning of therapy. Although the therapy is generally considered to be well tolerated, everyone reacts individually, and here too there are undesirable reactions that must be detected and treated in a timely manner.
How do you deal with this in neurology at UKL and do you prepare for it?
Prof. Saur: The topic keeps us on our toes. The German Alzheimer Society assumes that there will be 430,000 new cases of dementia per year in Germany. In regarding three quarters of cases it is Alzheimer’s disease. Alzheimer’s therapeutics might therefore quickly move into the group of the most prescribed drugs.
However, the structures are not yet prepared for this. We are currently working on changing that and becoming a pioneer in this area. The resident neurologists in the practices will be able to achieve a lot here, but will undoubtedly not cover everything completely.
We are anticipating a high level of demand, and we want to equip our dementia consultation hours accordingly. But we are also preparing to carry out further research at this point. We don’t yet know what effects the therapies will have in the long term; that needs to be monitored and evaluated.
But overall this is a big step. What we are experiencing here is just a beginning. There will be other approaches, for example for diagnosis using a blood test, and also for therapy. Because even if we can now fight the amyloid deposition once morest the second cause of Alzheimer’s disease, the altered tau proteins, development is not yet at that stage.
Specialist event on the topic
The neurologists at Leipzig University Hospital are offering a specialist symposium on this topic on November 29th for interested specialist audiences.
You can find more information regarding this here: Clinical Neuroscientific Colloquium: Minisymposium “Dementia” (uniklinikum-leipzig.de)
1698927464
#therapies #milestone #Alzheimers #cured #University #Hospital #Leipzig #AöR #press #release
