In a significant breakthrough for Alzheimer's disease treatment, the pharmaceutical company Eli Lilly has reported that its drug, donanemab, can slow the progression of the disease by approximately one-third. This revelation marks the second major drug in under a year to demonstrate such promising results, leading experts to assert that we are now on the verge of a new era in Alzheimer's treatments, a development that had previously seemed unattainable.
Donanemab, like its predecessor lecanemab, operates as an antibody, engineered to combat beta amyloid, a sticky substance that accumulates between brain cells, forming plaques that are a hallmark of Alzheimer's disease. Eli Lilly's trial involving 1,734 individuals in the earliest stages of the disease revealed that donanemab, administered as a monthly infusion, led to the elimination of these plaques and slowed the progression of Alzheimer's by approximately 29% overall, and up to 35% in a subset of patients deemed more likely to respond positively.
Furthermore, patients receiving the drug demonstrated the preservation of essential aspects of their daily lives, such as engaging in discussions about current events, driving, and pursuing hobbies. However, it is crucial to note that brain swelling emerged as a common side effect, with up to a third of patients experiencing mild or asymptomatic swelling detected through brain scans. While most cases were not severe, 1.6% of patients experienced dangerous brain swelling, resulting in two deaths directly linked to this complication, with a third volunteer passing away after experiencing a similar case.
Dr. Mark Mintun, Eli Lilly's group vice-president of neuroscience research and development, acknowledged the potential clinical benefits of donanemab but highlighted the associated risks that may be serious and life-threatening. The company plans to initiate the process of seeking approval for the drug's use in hospitals within the next few months, although further research and consideration of the drug's side effects will be necessary.
The emergence of two drugs that effectively target amyloid in the brain to slow the progression of Alzheimer's disease provides a significant boost to the scientific community's confidence in this approach after years of setbacks and disappointments. Professor John Hardy, from the UK Dementia Research Institute, credited for pioneering the idea of targeting amyloid three decades ago, believes that the existence of two drugs targeting the same mechanism is favorable for competition and further advancements.
Dr. Susan Kolhaas, representing Alzheimer's Research UK, expressed optimism, stating that the possibility of a first generation of Alzheimer's treatments is within reach, an outcome that many deemed impossible just a decade ago. However, it is important to note that these drugs have shown effectiveness primarily in the earliest stages of the disease, before significant brain damage occurs.
To fully leverage the potential of these treatments, there is a need for a revolution in the diagnosis of Alzheimer's disease. Currently, only a small percentage of individuals undergo brain scans or spinal-fluid analysis to determine their specific form of dementia, rendering the drugs ineffective for the majority of cases. Additionally, the affordability and accessibility of these treatments would need to be considered by healthcare systems, such as the National Health Service (NHS), to ensure equitable access to effective Alzheimer's care.
As the global community strives towards achieving the Sustainable Development Goals (SDGs), the development of effective Alzheimer's treatments holds great significance. By addressing the healthcare needs of aging populations, promoting inclusive and sustainable healthcare systems, and fostering research and innovation, society can enhance the quality of life for individuals affected by Alzheimer's and contribute to the goal of leaving no one behind.
More information[DCG1] [MOU2] : https://www.bbc.com/news/health-65471914
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