HWN Suggests

Why Isn’t There an Effective Alzheimer’s Treatment Yet?

For decades, there had been no real medical game changers in Alzheimer’s research—until last year. The FDA approved a controversial drug, one with only mixed clinical results. At this point, even the manufacturer of this drug, called Aduhelm, has all but abandoned it. There might be another medication on the horizon—lecanemab—but solely for people in the early stages of the disease. Why is it taking so long for Alzheimer’s patients and their families to get any relief?

read full article

Featured

  Alzheimer Disease: Are the Treatments Worse Than the Illness?

Although aducanumab made a big splash in the news, there are a number of treatment options available. To evaluate where we are in addressing AD, Psychiatric Times™ took a closer look at some of the biggest names in the treatment arena. When were they approved, what are their effects, and how much are they costing patients?

 Alzheimer’s Disease Treatments: What to Know About New and Future Drugs

Newly approved Leqembi promises to slow the disease, but patients will have to consider risks and reimbursement

 Are New Alzheimer’s Drugs Worth the Risk?

After decades of clinical trial failures, two new Alzheimer’s drug approvals by the Food and Drug Administration (FDA) have thrilled many healthcare providers and advocacy groups. Others warn that the two new drugs, Aduhelm (aducanumab) and Leqembi (lecanemab-irmb), may not be the medical miracles they seem to be. Doctors have been using the same drugs and lifestyle adjustments to treat Alzheimer’s for years with modest benefits at best. None of these drugs can stop, slow, or reverse the seemingly inevitable progression of Alzheimer’s disease. They may temporarily reduce the condition’s symptoms.

 Eli Lilly's Alzheimer's Drug Shows Greatest Benefit Yet

In the Phase 3 study, which included more than 1,000 people with early signs of Alzheimer’s disease, people receiving donanemab experienced 35% slower cognitive decline, as measured on cognitive tests, than people receiving placebo. In addition, those getting the drug showed 40% less decline in the ability to perform daily activities such as driving, managing their finances, and holding conversations. That’s an important metric for patients and their caregivers, as it can help more people live as independently as possible for as long as possible as the disease progresses.

 FDA approves Alzheimer's drug that appears to modestly slow disease

Lecanemab, which will be marketed as Leqembi, is likely to reach many more patients than a similar product, Aduhelm, which flopped after receiving a controversial approval in 2021. But Leqembi, like Aduhelm, can cause swelling or bleeding in the brain, which means patients must receive periodic brain scans after starting treatment.

 How Exactly Do Different Kinds of Alzheimer’s Medications Work?

While they're not a cure, they can help manage symptoms. There are two major classes of Alzheimer's medications, which are FDA-approved to treat symptoms at specific stages of the disease.

 Listen: Is the medical system ready for Alzheimer’s drugs that work?

An effective treatment for Alzheimer’s disease has long been a holy grail in the pharmaceutical industry. In early June, some hope appeared when the FDA agreed that the anti-amyloid antibody lecanemab (to be sold by Eisai as Leqembi) outperformed placebo in trials. It is expected to receive full approval by July 6. But this may not necessarily be purely good news.

 New Alzheimer’s drugs don’t deserve the hype – here’s why

Enter three drugs (aducanumab (trade name Aduhelm), lecanemab (Leqembi) and donanemab) that remove amyloid, the protein thought to cause Alzheimer’s disease. Unlike their many predecessors, that also successfully removed amyloid from the brain, these drugs were the first to slow cognitive decline. This breakthrough was hailed as “the beginning of the end for Alzheimer’s disease”, but how useful are these drugs going to be? There are four key shortcomings to consider...

 Why the Next Big Hope for Alzheimer’s Might Not Help Most Black Patients

With the FDA’s approval of lecanemab, Eisai is set to promote it to the primary care physicians who treat most dementia patients and critics are speaking out. Some say the drug, which Eisai plans to market for $26,500 a year, offers false hope. Others say any positive impact it has won’t benefit lower-income patients, who tend to be diagnosed too late for the drug to be effective, and usually receive care in settings ill-equipped to handle the drug’s stringent requirements.

Articles of Interest

A drug for Alzheimer’s disease that seems to work

It is not perfect. And it has side-effects. But it may be the real deal

Alzheimer's: Drugs Help Manage Symptoms

Alzheimer's drugs might be one strategy to help slow or manage memory loss, thinking and reasoning problems, and day-to-day function. While Alzheimer's drugs don't cure the disease, they can improve quality of life and help prolong independence.

Alzheimer’s Drug May Benefit Some Patients, New Data Shows

The drug, lecanemab, made by Eisai and Biogen, also carried risks of brain swelling and bleeding and should be studied further, a report of the findings said.

Alzheimer’s drugs are a ray of hope. They must be accessible to all, not the wealthy few

Developing treatments for Alzheimer’s has been a challenge, with almost 20 years passing with no new drugs. But in the last year, two new ones have emerged: donanemab and lecanemab. Neither are cures or magic bullets for the disease, but they do address key symptoms.

Assessing Alzheimer’s Medications

While there is no cure, there are currently several available treatment options for patients with AD that can improve their symptoms and quality of life. Worldwide medical research is under way for a breakthrough discovery to cure this destructive disease.

Can curcumin spice treat Alzheimer’s disease?

The main source of the “improves memory” claim are studies reporting that people who eat a lot of curry, which contains turmeric, have better cognitive function than people who eat little. But that says nothing about cause and effect; maybe smart people eat more curry than less-smart people do. There is no rigorous evidence that curcumin does anything for Alzheimer’s.

Curcumin improves memory and mood, new UCLA study says

Lovers of Indian food, give yourselves a second helping: Daily consumption of a certain form of curcumin — the substance that gives Indian curry its bright color — improved memory and mood in people with mild, age-related memory loss, according to the results of a study conducted by UCLA researchers.

Current Treatments for Alzheimer's Limited

Cholinesterase inhibitors are designed to prevent the breakdown of acetylcholine, a chemical messenger important for memory and other cognitive functions, and keep levels high even when the cells that produce it degenerate or die. Of this class of drugs, the most commonly prescribed are donepezil (Aricept); rivastigmine (Exelon) and galantamine (Reminyl). About half the people taking these drugs experience a modest improvement in memory and other thinking skills.

Do Alzheimer’s Medications Really Help?

Critics of these medications point out that their effects differ from those of placebo (inert medication) by only a few points on scales that include many points. They also criticize the potential of the cholinesterase inhibitors to induce distressing side effects such as severe diarrhea or fainting. A practical approach to the use of these medications requires periodic reassessment of their side effects and benefits.

I thought I could fix my Alzheimer’s patients. I learned to help them instead

Cognitive impairment interested me. One of my grandmothers had had Alzheimer's, but it wasn't a disease I knew a great deal about. I wanted to learn more. I wanted to quit my tedious day job and help people instead of selling them things they didn't want or need.

Living Well, Even With Alzheimer’s

Many people have the idea that Alzheimer’s disease is a one-way street to inexorable decline, but patients can remain active and engaged.

Lots of ‘breakthroughs’, still no cure. Do the new dementia drugs bring us any closer?

Two new “breakthrough” drugs have been in the news. While they may not bring much relief to those living with the disease today, we are learning more about dementia, and getting closer to a treatment.

Turmeric and dementia

There is currently limited evidence from research studies in people to suggest that turmeric, which is a type of spice, can prevent or treat dementia.

Turmeric Curcumin and Alzheimer's Disease

Turmeric, which contains a significant amount of Curcumin, has long been a staple ingredient in many asian foods. Researchers have theorized that the significantly lower rates of dementia and Alzheimer’s in asian cultures could be attributed to the higher consumption of Curcumin. In fact, studies examining the consumption of Curcumin showed that individuals whom consumed more Curcumin performed better on mental tests later in life.

Use of curcumin in diagnosis, prevention, and treatment of Alzheimer's disease

Because of its multi-target effects, curcumin has protective and preventive effects on many chronic diseases such as cerebrovascular disease, hypertension, and hyperlipidemia. For prevention and treatment of Alzheimer's disease, curcumin has been shown to effectively maintain the normal structure and function of cerebral vessels, mitochondria, and synapses, reduce risk factors for a variety of chronic diseases, and decrease the risk of Alzheimer's disease.

Resources

30 Years On, Are We Winning the Fight Against Alzheimer’s?

There are a variety of treatments in development for later stage Alzheimer’s patients, such as sigma2, growth factor receptor modulators and some tau-targeting therapies, but none have yet demonstrated convincing clinical evidence of efficacy.