Early diagnosis call following Alzheimer’s drug success

Campaigners have called for new efforts to achieve accurate early diagnosis of Alzheimer’s disease after a conference heard promising results from a new monoclonal antibody treatment.

The drug, donanemab, was found to have reduced progression of disease by more than 20% in patients in the early stages of the disease, according to a report to the Alzheimer’s Association International Conference in the USA, published simultaneously in the Journal of the American Medical Association.

Some 1,736 people took part in the randomised, doubled blinded international study of the drug developed by Eli Lilly.

Researchers said detailed analysis of their findings suggest the drug may be most effective in the earliest stages of police – reducing decline by between 46 and 60%, depending on the measurement used.

There were also indications of some patients suffering serious side effects. There were three deaths in the group taking the drug compared with one in the placebo group associated with taking the drug.

The research took place in the USA, Sweden and Scotland.
Alzheimer’s Society chief executive Kate Lee said it was a “defining” moment”. The drug is designed to target amyloid plaque and clear it.

Lee said: “New treatments could mean nothing if we don’t fix dementia diagnosis. We estimate around 720,000 people in the UK could potentially benefit from these emerging new Alzheimer’s disease treatments if they’re approved for use here. But the NHS is simply not ready to deliver them.

“Timely, accurate diagnosis is key, and currently only 2% of people in England and Wales receive their diagnosis through the specialist investigations needed to be eligible for these treatments.

“Alongside this, these emerging Alzheimer’s disease drugs require regular infusions and monitoring, and the NHS is not yet equipped to do this at scale.”

The society’s associate director of research Dr Richard Oakley said:

“This is truly a turning point in the fight against Alzheimer’s and science is proving that it is possible to slow down the disease. Treatments like donanemab are the first steps towards a future where Alzheimer’s disease could be considered a long-term condition alongside diabetes or asthma. People may have to live with it, but they could have treatments that allow them to effectively manage their symptoms and continue to live fulfilled lives.”

Dr Oakley added: “Regulators will need to balance these side effects against the benefits of the drug. We should also note that the majority of people who took part in this trial were white – it’s crucial that in future trials we see more diversity to prove that new drug treatments have similar effects for everyone living with Alzheimer’s disease.”

Researcher Professor Liana Apostolova, of the Indiana University School of Medicine, USA, said: “These results demonstrate that diagnosing and treating people earlier in the course of Alzheimer’s disease may lead to greater clinical benefit. The delay of disease progression over the course of the trial is significant and will give people more time to do such things that are meaningful to them.”

Donanemab in Early Symptomatic Alzheimer Disease. The TRAILBLAZER-ALZ 2 Randomized Clinical Trial. JAMA 17 July 2023

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