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Alzheimer’s disease can devastate the lives of patients, their loved ones and caregivers. The heartbreak and daily trials that come with loss — including memory loss, loss of identify and losing the person you once knew — can derail entire families as they rise to the challenge of caring for their loved person who seems to slip from their fingertips as the disease progresses.
Trailblazing the path to hope are two drugs meant to fight the impact of Alzheimer’s by effectively slowing the disease. They are called Leqembi and donanemab; both medications have the Food and Drug Administration’s full approval — an extraordinary moment in the history of medicine as this is the first time a drug meant to slow the progression of Alzheimer’s disease has been granted full regulatory approval.
What Are the New Alzheimer’s Drugs?
The two new drugs that target Alzheimer’s disease are Leqembi, made by Eisai in Japan and Biogen in the U.S., and donanemab, made by American pharmaceutical company Eli Lilly. Both aim to achieve the same thing — slow the progression of the disease rather than relieve its symptoms.
Leqembi targets a type of protein in the brain called beta-amyloid, historically thought of by scientists as one of the underlying causes of Alzheimer’s disease.
Donanemab is an antibody therapy that targets abnormal clumps of a protein called beta-amyloid that can build up in the brain. The plaques are considered one of the pathological hallmarks of Alzheimer’s disease.
The medication works by binding to the abnormal amyloid and removing it from the brain. It works quickly and can clear nearly 90% of amyloid plaque from the brain; removing it early enough can reduce any damage caused to the brain and successfully slow the rate of cognitive decline. In a study of 1,700 individuals, disease progression was slowed by 35%, the most significant effect ever observed in a trial for an Alzheimer's disease modifying drug.
Both donanemab and Leqembi have similar therapeutic targets, but the two antibodies utilized markedly different trial designs.
How Do These Drugs Help Alzheimer’s Patients?
While neither drug is a cure for Alzheimer's disease, the potential impact they'll have on slowing the rate of cognitive decline can significantly improve patients' quality of life by allowing them to live more independently, enjoy their hobbies and loved ones, maintain their well-being, and essentially live a whole life that they find meaningful.
Are the Drugs Safe?
In light of Leqembi’s approval, the FDA also included its strongest warning label — a boxed warning — about specific side effects, including brain swelling and hemorrhage, noting the possibility of seizures and death. Additionally, before starting the medication, patients should undergo genetic testing to better understand their risk for these side effects.
As for donanemab, the AD field will also closely monitor the forthcoming trial results for the side effect known as ARIA-E—a type of brain swelling that, although usually reversible, can be serious.
Ushering in a New Era for Alzheimer’s Treatment
The results with both drugs demonstrate solid evidence that removing amyloid from the brain can slow down Alzheimer's disease. Another reason for success is earlier treatment when patients’ brains are still relatively healthy.
That said, between effective medication, earlier detection and treatment, and lifestyle management for patients with Alzheimer's, we may be moving closer toward a new era, offering hope and healing to those impacted by Alzheimer's.
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