Experimental Alzheimer’s drug may slow disease progression, but there are risks: experts
The experimental drug lekanemab showed a slowing down of the progression of cognitive decline by 27% in patients with early stage of Alzheimer’s diseaseaccording to a study published this week in the New England Journal of Medicine.
“These findings show that lekanemab holds promise for people with early Alzheimer’s disease, s significant slowdown in decline and a reasonable safety profile,” said the study’s lead researcher, Dr. Christopher H. Van Dyck, in an interview with Fox News Digital.
Van Dyck is director of the Alzheimer’s Disease Research Unit and professor of psychiatry, neurology, and neuroscience at Yale University School of Medicine.
In the study, Van Dyck researchers said the drug lekanemab “reduced amyloid markers in early Alzheimer’s disease and resulted in moderately less decline in cognition and function than placebo at 18 months—but was associated with side effects.”
Pharmaceutical company Eisai Co. Ltd. and Biogen Inc.he developed a cure.
The drug is a monoclonal antibody — it interferes with the formation of amyloid plaque, which according to experts is considered the main culprit in Alzheimer’s disease.
‘Associated with less clinical decline’
The research included 1,795 participants who had early Alzheimer’s disease.
Of the participants, 898 received lekanemab, while 897 received a placebo at 235 sites in North America, Asia and Europe from March 2019 to March 2021, according to the study.
Participants received lekanemab intravenously every two weeks over a period of 18 months.
“Analyses at 18 months showed dose- and time-dependent clearance of amyloid with lekanemab, and the drug was associated with less clinical decline on some measures than placebo,” the researchers said in the published study.
The lekanemab group reflected a slower progression of cognitive decline.
The researchers relied on a tool that measures cognitive impairment. It’s called the Clinical Dementia Rating Framework Sum (CDR-SB) — it tracks participants’ progress.
Mean baseline scores were approximately 3.2 in both the lekanemab and placebo groups. A score of 0.5 to 6 is consistent with early Alzheimer’s disease, according to the researchers.
After 18 months of treatment, the average score in the lekanemab group increased by 1.21 points, compared with patients in the placebo group — whose score increased by 1.66 points.
The lekanemab group reflected a slower progression of cognitive decline.
Some participants experienced adverse events, the researchers noted.
About 20% of patients receiving lekanemab experienced brain swelling or bleeding in the brain, according to the study.
Lekanemab is ready for FDA approval in early 2023.
Eisai said two deaths have occurred, although they are not believed to be related to lekenamab.
Alzheimer’s Drug Discovery Foundation (ADDF) officials said in a statement that lekanemab, which is in the pipeline for FDA approval in early 2023, represents a positive step toward treating the disease and “welcome news for the millions of patients and families living with Alzheimer’s disease. .”
dr. Howard Fillit, co-founder and chief scientific officer at ADDF, also said in a statement: “But this is just the beginning of stopping Alzheimer’s in its tracks. We have a lot more to cover to get from the 27% slowdown [that] lekanemab offers our goal of slowing cognitive decline by 100%.”
The ADDF press release says that drugs to remove amyloid are part of the solution to Alzheimer’s disease.
However, further development of a new generation of drugs that can target specific pathologies that contribute to the disease is needed.
The Alzheimer’s Association said it was encouraged by the global clinical trial of lekanemab.
“Unique drug combinations tailored to each patient’s underlying pathology are the answer and our best hope to provide patients with long-term relief from this insidious and progressive disease,” Fillit said in a released statement.
The Alzheimer’s Association also released a statement on the results of the third phase of the trial.
On its website, the group said it was encouraged by the global clinical trial of lekanemab.
It said the study “confirms that this treatment can significantly change the course of the disease for people in the earliest stages of Alzheimer’s disease. The Alzheimer’s Association is urging the Food and Drug Administration to expedite approval of lekanemab.”
The organization also noted in part, “These peer-reviewed, published results show that lekanemab will give patients more time to participate in daily life and live independently. This could mean many months more recognition their husband, children and grandchildren.”
“Statistically significant does not always mean practically significant, especially not in the context of significant risks.”
dr. Marzena Gieniusz, medical program director of the Alzheimer’s and Dementia Care (ADC) Program at Northwell Health at Long Island, New Yorkhe commented on the findings.
dr. Gieniusz, who was not involved in the study, said she was excited to see a statistically significant difference between the lekanemab and placebo groups in the study — but cautioned that more research is needed on the drug.
“Statistically significant does not always mean practically significant, especially not in the context of significant risks noted in the study, as well as risks not yet evident — including the potential for increased hospitalizations, unnecessary interventions, etc.”
Gieniusz also told Fox News Digital, “While I am pleased to see the results so far, I am eager to learn more, including about safety and efficacy, before meaningfully researching and considering the practical risks, benefits, and alternatives of this drug.”
Van Dyck of the Alzheimer’s Disease Research Unit told Fox News Digital that further research is currently underway – and that the researchers need participants.
“The next steps in our evaluation of this treatment will certainly be to approach asymptomatic, at-risk individuals even earlier.” (A preclinical Alzheimer’s disease trial is ongoing as of 2019, but enrollment is late.)
Van Dyck said he was “optimistic” that “the results will stimulate interest and enrollment and allow us to complete this important study.”
Van Dyck also said he was “optimistic” that “the results will stimulate interest and enrollment and allow us to complete that important study. In addition to the important effects in early AD symptoms, we would like to know if this can significantly increase the treatment of individuals before major damage occurs and significant symptoms begin.”
Also, according to the Alzheimer’s Association, there is a potentially costly problem with the Centers for Medicare and Medicaid Services (CMS). a policy that could block access to treatment if the FDA approves it.
“The FDA is expected to decide whether to grant accelerated approval for lekanemab by January 6, 2023,” the association said.
“If the FDA does this, CMS’s current policy will prevent thousands upon thousands of Medicare beneficiaries with terminal, progressive disease from accessing this treatment within the limited time period they will have access to.”
The association said CMS has pledged to quickly change the policy if new evidence is presented.
Now, given the new evidence, “CMS can begin its review immediately,” the association said. “The Alzheimer’s Association urges CMS to revise its policy with the utmost urgency.”