- By Fergus Walsh, Michelle Roberts
- BBC news
image source, Getty Images
A new drug, donanemab, has been shown in global trials to slow cognitive decline and is being hailed as a turning point in the fight against Alzheimer’s disease.
Antibody drugs help in the early stages of the disease by removing proteins that build up in the brains of people with this type of dementia.
Not a cure, but charity publishes results in magazine JAMA It ushers in a new era in which Alzheimer’s disease can be treated.
Britain’s drug regulator has begun evaluating it for possible use on the NHS.
The drug works for Alzheimer’s disease, but not for other types of dementia, such as vascular dementia.
Studies suggest that the rate of disease progression slowed by about a third, and people were able to hold more of their daily routines and tasks, such as preparing meals and enjoying hobbies.
80-year-old Mike Colley is one of just a few dozen patients in the UK to participate in a global trial. He and his family spoke exclusively to the BBC.
Mike, who receives IVs every month at a clinic in London, says he’s “one of the luckiest people I’ve ever met”.
Mike Collie (left) with his son Mark
Shortly before the trial began, Mike and his family realized that he was having memory and decision-making problems.
His son Mark said it was very painful to watch at first. “Watching my son struggle with information processing and problem solving was very painful, but I think the decline has plateaued now.”
Mike, who is from Kent, said, “I feel more confident day by day.”
Although these drugs show great promise, they are not without risks.
Brain swelling was a common side effect in up to one-third of patients in the donanemab trial. In most cases this resolved itself without causing any symptoms. However, two volunteers, possibly a third, died as a result of dangerous swelling of the brain.
Another antibody Alzheimer’s drug called aducanumab was recently rejected by European regulators, citing safety concerns and a lack of evidence that it works well for patients.
What is dementia and what can be done about it?
In the donamab trial, researchers tested 1,736 people with early Alzheimer’s disease aged 60 to 85.
Half of them were treated with monthly intravenous fluids, and the other half received a dummy drug, also called a placebo, for 18 months.
- The drug appears to have a meaningful effect for at least some patients.
- In terms of clearance seen on brain scans, those with early disease and low baseline brain amyloid benefited more.
- Those who received the drug were also able to maintain more of their daily routines, such as discussing current affairs, answering phone calls, and pursuing hobbies.
- The pace of disease progression slowed by about 20-30% overall, judging by what people can still do on a daily basis, and 30-40% in a series of patients the researchers thought were more likely to respond. .
- Serious side effects and patients need to be aware of treatment risks
- Half of the patients who received donemab were able to discontinue treatment after 1 year because the brain deposits were sufficiently cleared
Amyloid is just one part of Alzheimer’s disease’s complex picture, and it’s unclear whether treatments will continue to make more changes over time, experts warn.
Before and after scans show how the drug removed deposits (seen in green, yellow and red) from the brain
The drug’s effects may be modest, but the results suggest that it could alter the course of Alzheimer’s disease by clearing the brain of amyloid, and if treated at the right time, could lead to this devastating disease. The researchers say it further supports its potential to help people who have been diagnosed with cancer.
Professor Giles Hardingham of the UK Dementia Research Institute said: “It’s great to see these results released in full today. We have waited so long for a cure for Alzheimer’s disease that this It’s really encouraging to see visible progress in the field continuing to pick up the pace.” . ”
Dr Susan Koolhaas, Alzheimer’s Research UK, said: “Today’s announcement marks another milestone. Thanks to decades of research, the landscape of dementia and its impact on people and society is finally changing. , we are entering a new era of Alzheimer’s disease.” It may become treatable. ”
Former Prime Minister David Cameron told BBC Radio 4’s PM program that resources should be invested in further research into what he called ‘statins for the brain’.
“People who have accumulated these proteins in their brains would like a pill that they can take daily or weekly to remove these proteins from their brains and reduce their chances of developing dementia-causing diseases. “He said.
Asked if the government would be willing to invest where needed to roll out new treatments, Cameron said he had real incentives to do so, adding: “We are a country of 60 million people. One million people have dementia, many of them in severe condition.” With expensive residential care homes, treating people effectively can save a lot…we hope our system can work. ”
Lecanemab is priced at approximately $27,500 (£21,000) in the US where it is licensed.
It’s unclear how much Donanemab will cost in the UK or how long it will take to get approval, but Alzheimer’s disease experts say having the two drugs in line will encourage price competition. rice field.
The UK drug watchdog NICE said it had already begun evaluating donanemab in the treatment of mild cognitive impairment and mild dementia due to Alzheimer’s disease.
“Our aim is to develop a recommendation for use in the NHS as soon as UK authorization is available,” said a spokeswoman.
Mike celebrating his 80th birthday
Mike Corry turned 80 in April. At his own birthday party, he surprised his family by singing My Way in front of 40 guests.
He told BBC News: “That’s the confidence I have now. Even 12 months ago it would never have happened.”
“I never thought I’d see my dad so energetic again. It was an unbelievable moment,” added his son Mark.
Dr. Emer MacSweeney, a consultant neuroradiologist and medical director at Re:Cognition Health, led a trial of donanemab in the UK.
“This is really important and one of the biggest advances,” she said.
“This is truly a turning point in the fight against Alzheimer’s disease, as science is proving that it is possible to slow the progression of the disease,” said the Alzheimer’s Association.
About 720,000 people in the UK could benefit from these new Alzheimer’s drugs if they are approved for use, but the Alzheimer’s Association said the NHS “simply isn’t ready to deliver them.” No,’ he said.
Kate Lee, CEO of the charity, said: “A timely and accurate diagnosis is key, but currently in England and Wales there is a need to qualify for these treatments. Only 2% of people get their diagnosis after thorough professional investigation.”
“Additionally, these emerging Alzheimer’s drugs require regular infusions and monitoring, which the NHS is not yet equipped to do at scale.”
