What is the new drug?

A ground breaking drug called donanemab is being hailed as a major turning point in the fight against Alzheimer’s disease. Results from a global trial have confirmed that the drug effectively slows down cognitive decline in individuals with this type of dementia.

Donanemab, an antibody medicine, specifically targets a protein that accumulates in the brains of Alzheimer’s patients. While it is not a cure, the findings published in the journal JAMA indicate a significant advancement in the treatment of Alzheimer’s, offering hope for a new era of managing the disease.

The drug is currently undergoing assessment by the UK’s drugs watchdog for potential use within the National Health Service (NHS). It should be noted that donanemab is designed to address Alzheimer’s disease specifically, and not other forms of dementia like vascular dementia.

How effective is the drug?

During the clinical trials, donanemab demonstrated the ability to slow down the progression of Alzheimer’s by approximately one-third. This allowed participants to retain more of their daily activities and quality of life, such as cooking and pursuing hobbies.

How does it help patients?

An 80-year-old participant in the UK, one of the few dozen involved in the global trial, receives monthly infusions of donanemab at a London clinic. His family witnessed his struggles with memory and decision-making before joining the trial, but they have now noticed a plateau in his decline. Many patients have reported increased confidence and well-being over time.

Developed by Eli Lilly, donanemab operates similarly to lecanemab, another drug created by Eisai and Biogen, which gained global attention for its ability to slow down Alzheimer’s progression. However, it’s important to acknowledge that these drugs, while promising, do carry risks and potential side effects.

Brain swelling was a common side effect experienced by up to a third of participants in the donanemab trial. In most cases, the swelling resolved without causing noticeable symptoms. Unfortunately, two participants, and possibly a third, experienced fatal brain swelling. It’s worth noting that European regulators recently rejected another Alzheimer’s drug, aducanumab, due to safety concerns and insufficient evidence of its effectiveness for patients.

A ground-breaking trial on the drug donanemab has shown promising results in the fight against Alzheimer’s disease. The study involved 1,736 participants aged 60 to 85 with early-stage Alzheimer’s. Half of them received monthly infusions of donanemab, while the other half received a placebo over 18 months.

The key findings are as follows:

– The drug demonstrated significant benefits, particularly for certain patients.

– Those with earlier-stage disease and lower levels of brain amyloid experienced greater clearance of amyloid on brain scans.

– Participants who received the drug retained more cognitive abilities, such as discussing current events, answering the phone, and pursuing hobbies.

– The progression of the disease, as measured by day-to-day functioning, was slowed by approximately 20-30% overall, and up to 30-40% in a subset of patients deemed more likely to respond.

– However, notable side effects were observed, and patients need to be aware of the potential risks associated with the treatment.

– Half of the patients receiving donanemab were able to discontinue treatment after a year, as their brain deposits had been sufficiently cleared.

– It remains uncertain if the treatment will have a sustained impact over a longer period, as Alzheimer’s is a complex condition with multiple factors involved.

Although the drug’s effects may be modest, these results reinforce the notion that removing amyloid from the brain could alter the course of Alzheimer’s and benefit those affected by the disease if treated at the appropriate stage.

Experts from the UK Dementia Research Institute and Alzheimer’s Research UK view the publication of these results as a significant milestone, signaling a shift in the outlook for dementia and the potential for Alzheimer’s to be treated.

The UK’s National Institute for Health and Care Excellence (NICE) has already begun evaluating donanemab for the treatment of mild cognitive impairment or mild dementia caused by Alzheimer’s disease.

The Alzheimer’s Society describes this development as a turning point in the fight against Alzheimer’s, with scientific evidence demonstrating the possibility of slowing down the disease. If approved, these emerging Alzheimer’s treatments could benefit approximately 720,000 people in the UK.

Source BBC