A new Alzheimer’s drug called Donanemab has shown promising results in slowing down the disease’s progression, which is caused by a sticky substance called beta-amyloid that builds up in the brain. Donanemab works similarly to another drug called Lecanemab, which was previously shown to have the same effect.
Both drugs are antibodies engineered to target and remove beta-amyloid from the brain. This breakthrough could mark the beginning of a new era in the treatment of Alzheimer’s, where patients can hope to manage the disease in the long term, rather than relying on palliative care.
Trials for the Donanemab
The trial for Donanemab involved 1,734 participants in the early stages of Alzheimer’s, who received monthly infusions of the drug until their beta-amyloid plaques were gone.
The results showed an overall 29% reduction in the pace of the disease, with a 35% reduction in patients thought to be more responsive to the drug. Patients given the drug also retained more of their daily abilities and functions.
However, up to a third of patients experienced brain swelling as a side effect, with 1.6% developing dangerous swelling that resulted in two deaths and one case where death followed the swelling.
Despite this, the pharmaceutical company, Eli Lilly, is encouraged by the clinical benefits of Donanemab and is seeking approval for its use in hospitals.
According to the associate professor in dementia neurology, at the University of Bristol, Dr. Liz Coulthard said, “Donanemab seems to help people with early Alzheimer’s retain cognitive function for longer – and this effect looks to be clinically meaningful. Donanemab might help people live well with Alzheimer’s for longer. If approved alongside lecanemab, this potentially brings a choice of treatments for patients.”
What researchers have to say about it
According to Professor John Hardy, UK Dementia Research Institute, who came up with the idea of targeting amyloid 30 years ago, the availability of two drugs is excellent news for research. He said, “Having two drugs is great for competition.”
Breakthrough in fight against Alzheimer's disease as scientists say they've found a new drug that slows cognitive and functional decline by a third pic.twitter.com/b3sR915wo7
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Dr. Susan Kolhaas of Alzheimer’s Research UK said, “We’re now on the cusp of a first generation of treatments for Alzheimer’s disease, something that many thought impossible only a decade ago.”
However, these drugs seem to be effective only in the initial stages of the disease when the brain is not yet severely damaged. Moreover, their approval in the UK would require a major shift in how the disease is diagnosed.
Currently, only 1-2% of patients undergo either brain scans or a spinal-fluid analysis to determine whether or not they have Alzheimer’s, making these drugs ineffective for most patients.
Additionally, the NHS would have to consider whether it could afford the drugs, with Lecanemab costing over £21,000 per person per year.