Scientists give guidance on new treatments for early Alzheimer’s disease

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The American Academy of Neurology (AAN) has created an Emerging Issues in Neurology article aimed at guiding discussions about new monoclonal antibody treatments for Alzheimer’s disease.

These therapies remove amyloid-β plaques in the brain and offer potential relief for people affected by Alzheimer’s.

The guidance, published on July 26, 2023, is intended to inform neurologists, patients, and caregivers about these emerging treatments.

Details on the New Therapies: Lecanemab, Aducanumab, and Donanemab

The article uses available information on lecanemab, aducanumab, and donanemab. Lecanemab received traditional FDA approval on July 6, 2023, while aducanumab received accelerated FDA approval in June 2021 but awaits traditional approval.

Donanemab has yet to be approved, but a decision is expected in 2023. The article emphasizes that this information is not a clinical practice guideline but serves as interim guidance while more evidence is gathered.

Eligibility and Risks of Therapies

These therapies are currently eligible only for people with early symptomatic forms of Alzheimer’s, mild cognitive impairment, or mild dementia due to the disease.

Patients need to be counseled about certain genetic risk factors and should not have a history of specific types of strokes.

These cautions stem from the risk of amyloid-related imaging abnormalities (ARIA), a serious side effect involving brain swelling and bleeding that can lead to death.

Individuals on certain anticoagulant medications may not be eligible for these therapies due to this risk.

The aim of these therapies is to remove amyloid-β plaques and slow cognitive decline. However, the article stresses they are not a cure for Alzheimer’s.

The decrease in the rate of cognitive decline observed over 18 months in some studies may not be noticeable to patients receiving these therapies.

The article also raises concerns about the high cost of these treatments, noting additional expenses for diagnostic testing, administration, and safety monitoring.

There’s also concern about a shortage of neurologists and healthcare professionals needed to meet the anticipated demand.

The article emphasizes the need for diversity in future research, noting that Black and Hispanic individuals, who have higher incidence rates of dementia compared to white populations, have been underrepresented in studies to date.

Conclusion: The Future of Alzheimer’s Treatments

There is considerable optimism about the potential of anti-amyloid monoclonal antibodies to slow the progression of Alzheimer’s in some patients.

More research is necessary to identify who may benefit most from these therapies and how to optimize patient outcomes.

If you care about Alzheimer’s, please read studies about Vitamin D deficiency linked to Alzheimer’s, vascular dementia, and Oral cannabis extract may help reduce Alzheimer’s symptoms.

For more information about brain health, please see recent studies about Vitamin B9 deficiency linked to higher dementia risk, and results showing flavonoid-rich foods could improve survival in Parkinson’s disease.

The study was published in Neurology.

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