Drug to Treat Alzheimer’s Disease

Table of Contents

Alzheimer’s Disease

It is a progressive neurologic condition that causes the brain to shrink (atrophy) and brain cells to die.
- The disease is named after Dr Alois Alzheimer, who studied the disease.
Cause: Alzheimer’s disease is believed to be caused by the abnormal build-up of amyloid proteins in and around brain cells, hampering their functions.
Symptoms: Memory loss is the key symptom of Alzheimer’s disease and the affected person may find it difficult to remember recent events or conversations.
- There will be changes in their behaviour, including mood swings, depression, confusion, loss of cognitive functions, social withdrawal, changes in sleeping habits etc.

Effects: The most striking effect of Alzheimer’s disease is dementia, which causes continuous decline in thinking, behavioral and social skills that affects a person’s ability to function independently.
Preventive measures: Avoiding risk factors such as hypertension, smoking, diabetes, and obesity in order to maintain brain health across the lifespan.
Treatment: Currently, there is no treatment to cure Alzheimer’s disease. However, there are medications to slow progression of symptoms.

Lecanemab drug belongs to a class of drugs called monoclonal antibodies. These antibody-mediated drugs target beta amyloid protein.
- This protein deposition is seen in patients with Alzheimer’s disease, which disrupts cells function.
Amyloid plaques are considered to be an important target for treatment in Alzheimer’s and the drug performs the same job.
The trial:
- Participants were randomly assigned intravenous lecanemab or placebo. It was seen that lecanemab “robustly removed the amyloid plaques.”
- Primary outcome: The treatment showed a change in the score recorded at baseline when the trial began on the Clinical Dementia Rating–Sum of Boxes (CDR-SB).
- Secondary outcome: The trial displayed a change in amyloid burden on PET (positron-emission topography). Changes were observed in both the lecanemab group versus the placebo group.
Significance of the research:
- Development of a drug showing efficacy on clinical outcomes, particularly after such a long wait for a successful therapy for Alzheimer’s disease, is good news for Alzheimer’s patients.
- However, only those in the early course of the disease are likely to benefit from the drug.

Regular hospital visits: The drug needs to be delivered via weekly IV injections requiring hospital visits and close monitoring.
Amyloid monitoring: Amyloid disposition monitoring has to be conducted regularly using amyloid PET, which is not available in developing countries.
High cost: The drug may not benefit low-income and middle-income countries where most people with dementia live. This is due to the high cost associated with the treatment.
Side-effects: Fast-track approval of a drug with limited studies raises serious concerns about its possible side-effects. There are chances of serious side effects like hemorrhages in the brain and oedema (brain swelling).