As we mark another World Alzheimer’s Day, it’s clear that Alzheimer’s research is moving in an exciting direction. Recent advancements in therapy show the potential for real change in how this devastating disease is treated. But while there’s much to celebrate, significant challenges remain, and there’s still a long road ahead in making these treatments widely accessible.
Disease-modifying therapies open the door to slowing the course of the disease
Two key developments in the Alzheimer’s space have made headlines in recent months. Both drugs work by targeting amyloid plaques in the brain, which are thought to play a critical role in the progression of Alzheimer’s.
Leqembi® (lecanemab), the first disease-modifying treatment for Alzheimer’s, has received approval from both the FDA and, most recently, the MHRA. This is a landmark moment, as it represents the first available therapy in the UK designed to slow the progression of Alzheimer’s rather than just managing symptoms.
Kisunla® (donanemab), another promising therapy, has also been approved by the FDA, with a decision pending from the MHRA.
These approvals signal a turning point in dementia care. After years of focus on symptomatic treatments, we are finally entering an era in which slowing or modifying the course of the disease itself is possible.
Despite these breakthroughs, several challenges still need to be addressed
Alzheimer’s treatment is far from perfect, and several issues still need to be addressed. From my perspective, the greatest needs in Alzheimer’s care are centered around accessibility and safety.
Safety
Both Leqembi® and Kisunla® have been associated with Amyloid-Related Imaging Abnormalities (ARIA), which can include brain swelling and bleeding. These side effects contributed to the EMA’s decision to reject approval, highlighting the need for better safety profiles in future treatments.
Cost
Another major hurdle is the cost of these new therapies. Leqembi® is currently only available through private channels in the UK due to its high price tag. Given the expense, the NHS is grappling with how to justify reimbursement. This leaves many patients without access to potentially life-changing treatment.
Diagnostics
Perhaps the most significant barrier, however, lies in diagnostics. Both drugs require patients to test positive for amyloid plaques via a PET scan or lumbar puncture, both of which are costly, invasive, and not widely available. Currently, only 2% of the population undergoes these tests. While blood tests for amyloid are being explored as a cheaper and more accessible option, we are not there yet.
What is next for Alzheimer’s disease?
In my opinion, the future of Alzheimer’s treatment lies in improving diagnostic tools and expanding access to affordable, safe, and effective therapies.
Blood-Based Diagnostics
One of the most exciting research areas is the development of blood tests for amyloid plaques. Making testing less invasive and more affordable could significantly widen the pool of patients eligible for these new therapies.
New Treatment Modalities
While Leqembi® and Kisunla® are groundbreaking, they are just the start. Other disease-modifying treatments and new therapeutic approaches targeting tau proteins or inflammation offer additional avenues of hope.
Let’s Continue the Conversation
There’s no doubt that Alzheimer’s research is heading in the right direction, but there’s still much work to be done. If you’re interested in learning more about the latest developments in neurology or discussing how these developments could impact your pipeline or communications strategy, I would love to hear from you.