Breakthroughs in Alzheimer’s research

Subject : Science and technology

Section: Health

Concept :

Less than two weeks after an Alzheimer’s drug developed by Biogen and Eisai won full approval from the US Food and Drug Administration (FDA), Eli Lilly’s monoclonal antibody donanemab has been shown to significantly slow the progression of the disease if treated early.
Lecanemab, a monoclonal antibody sold under the name Leqembi, was granted “accelerated” approval this January for its ability to reduce amyloid beta protein plaques in the brain — a defining feature of Alzheimer’s — and got full approval this month after later-stage results demonstrated 27% slowing of cognitive and functional decline over 18 months in comparison to a placebo.

Challenges in bringing to India

Therapy with donanemab would require an early diagnosis, careful selection of patients, screening the eligible among them, and following up with expensive tests while watching for severe adverse events that may lead to death.
Those being screened would have to be tested for the APOE4 gene, which has been associated with a higher risk of adverse events.
The costs will be substantial, not just for the medication itself, but also for the biomarker and imaging workup.
The therapy slows the progression of the disease, but does not ultimately treat it.
While the phase 3 trial results of lecanemab and donanemab cannot be compared directly — they used different scales for measuring cognitive decline.
Main adverse effect with drugs that clear out amyloid beta proteins is amyloid-related imaging abnormalities (ARIA) such as swelling or bleeding in the brain, most of which is asymptomatic.
Alzheimer’s has multiple modalities and we need various therapies to address them. While the amyloid beta protein therapy has been at the forefront, there is a need to investigate other targets as well.

Alzheimer’s disease

Alzheimer’s disease is a brain disorder that slowly destroys memory and thinking skills and, eventually, the ability to carry out the simplest tasks.
The disease is named after Dr. Alois Alzheimer
It symptoms included memory loss, language problems, and unpredictable behavior.
In brain found many abnormal clumps (now called amyloid plaques) and tangled bundles of fibers (now called neurofibrillary, or tau, tangles).
These plaques and tangles in the brain are still considered some of the main features of Alzheimer’s disease.
Another feature is the loss of connections between nerve cells (neurons) in the brain.
This damage initially takes place in parts of the brain involved in memory, including the entorhinal cortex and hippocampus. It later affects areas in the cerebral cortex, such as those responsible for language, reasoning, and social behavior.