2023-05-04 12:49:39
- James Gallagher
- BBC science and medical reporter
New treatment gives hope to Alzheimer’s patients
We may be entering the era of Alzheimer’s disease treatment, after it was proven that the second drug manufactured in less than a year slowed the disease.
“We are now on the cusp of drug availability, which recently seemed impossible,” the experts said.
Eli Lilly has reported that its drug donanemab slows the rate of Alzheimer’s disease by about a third.
But two of the volunteers, and possibly a third, died as a result of serious brain swelling.
sticky substance
Donanemab works in the same way as lecanemab, which made headlines around the world when it was shown to slow disease.
Both consist of antibodies like those the body produces to attack viruses. But these substances are designed to remove a sticky substance from the brain called beta-amyloid.
Amyloid builds up in the spaces between brain cells, forming plaques that are one of the hallmarks of Alzheimer’s disease.
Dr Cath Mummery, Clinical Lead of the Cognitive Disorders Clinic at the UK’s National Hospital for Neurology, said: “The decades-long battle to find therapies that modify Alzheimer’s disease is changing. We are now entering a disease-modifying time when we might realistically hope to cure someone. patient with Alzheimer’s disease, through long-term management of the disease rather than palliative and supportive care.”
The full details of Eli Lilly’s assessment have not been released, but she revealed key findings:
1,734 people in the early stages of Alzheimer’s disease participated.
Donanemab was given monthly until the characteristic plaques in the brain disappeared.
The disease slowed by about 29% overall, and by 35% in the group of patients the researchers thought were more likely to respond.
Those given the drug also retained more of their daily living requirements, such as the ability to discuss current events, drive or pursue hobbies.
However, brain swelling was a common side effect in up to a third of patients.
The swelling was mostly mild or asymptomatic despite being detected on brain scans, but 1.6% developed serious brain swelling, with two people dying directly and a third volunteer dying after this case.
“We are encouraged by the potential clinical benefits that donanemab may provide, despite the associated risks that may be serious and life-threatening, as are many effective therapies for debilitating and fatal diseases,” said Dr. Mark Minton, vice president of Eli Lilly Research and Development. nerves.
The company said it would begin the process of licensing its drug for hospital use in the next few months.
Dr Liz Coulthard, from the University of Bristol, says there are “significant side effects and a lack of long-term data, but the drug can help people live well with Alzheimer’s for longer”.
“impossible idea”
The fact that two drugs slow the disease by targeting amyloid in the brain has also convinced scientists that they are on the right track after decades of misery and failure.
Prof John Hardy, of the UK’s Dementia Research Institute, whose work led to the idea of targeting amyloid 30 years ago, said: “This should dispel any lingering doubts about this approach. Taking two drugs is a great competition.”
Dr Susan Koolhaas, from Alzheimer’s Research UK, said: “We are now on the cusp of first-generation treatments for Alzheimer’s disease, something many thought impossible just a decade ago.”
However, these drugs only seem to work in the early stages of the disease, before the brain is severely damaged.
And if approved in the UK, it would take a revolution in how the disease is diagnosed to make a difference.
It is known that only 1-2% of people undergo brain scans or cerebrospinal fluid analysis to determine whether they actually have Alzheimer’s disease or another form of dementia against which drugs do not help.
The NHS will have to decide whether they can afford it.
Licanimab costs more than £21,000 per person per year.
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