Drug to Treat Alzheimer’s Disease

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.

More on the News

• Data of clinical trial has shown modest effects in arresting decline in cognitive and functional aspects in patients with early Alzheimer’s.
• This is a ray of hope for an estimated 55 million people living with the debilitating effects of Alzheimer’s disease.

What is Lecanemab Drug?

• 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.

Concerns Associated

• 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).

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