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Groundbreaking New Treatments in the Fight Against Alzheimer’s Disease

Groundbreaking New Treatments in the Fight Against Alzheimer’s Disease
"Alzheimer’s Disease is a complex condition with multiple causes and will require more than one treatment." (Credit: iStock)

Groundbreaking new treatments and research in the fight against Alzheimer’s Disease were presented at the 49th edition of Arab Health in Dubai by Re:Cognition Health’s CEO.

Throughout 2023, new-generation medication has shown itself to be effective in slowing the progression of Alzheimer’s Disease and its associated symptoms. In his lecture at Arab Health on January 29th, Dr Emer MacSweeney, CEO and Consultant Neuroradiologist at Re:Cognition Health—a pioneering clinic specializing in the diagnosis, treatment and care of patients with cognitive impairment and mental health concerns—detailed her cautiously optimistic outlook in tackling early-stage Alzheimer’s Disease. Incidentally, some of Re:Cognition Health’s patients took part in the clinical trials involving these new drugs.

Alzheimer’s Disease, the most common cause of dementia, is a brain disorder characterized by changes in the areas of the brain responsible for memory, thinking, language, behavior and social skills—all of which show gradual decline as the disease progresses. These changes lead to deposits of certain proteins that are toxic to the brain—for example, amyloid and tau, which are precisely the targets of the most promising new treatments.

According to Alzheimer’s Disease International (ADI), 55 million people worldwide were living with dementia in 2020 and that number is expected to triple by 2050 due to the aging global population. Hence the importance of developing drugs that can slow or ideally stop the progression of this condition.

Three New Drugs

1/ Lecanemab: Developed by Eisai, Lecanemab is a new monoclonal antibody that acts against the aforementioned amyloid protein. It was granted Federal Drug Administration (FDA) approval in 2023 and is currently under review by the United Kingdom’s Medicines and Healthcare products Regulatory Agency (MHRA) and by the European Medicines Agency (EMA).

Lecanemab is already on the market in the United States, China and Japan, and is available in many hospitals in India. In a global study involving 1,795 volunteers with early-stage Alzheimer’s Disease, patients who received fortnightly infusions of Lecanemab had a 27% reduction in the rate of progressive cognitive decline over 18 months compared to those on a placebo.

2/ Donanemab: Eli Lilly’s Donanemab is also a monoclonal antibody against toxic brain amyloid protein administered by infusion and is currently under review by the FDA. Of the 1,736 participants involved in a worldwide clinic trial, 35% showed a reduction in cognitive decline and a 40% reduction in functional decline related to daily living activities when compared to the placebo group.

The most impressive results, however, were noticed in the individuals who had the mildest cognitive symptoms at the time of commencing the study, with more than 60% reduction in functional decline; hence the importance of the earliest possible diagnosis.

3/ HMTM: Finally, TauRx’s HMTM is aimed against the tau protein and produced exciting results in tests completed in 2023. It is currently being submitted to the FDA, MHRA and other regulators. Unlike the amyloid monoclonal antibodies, this medication can be taken orally.

Alzheimer’s disease has destroyed neurons in the right-hand brain. (Credit: Jessica Wilson/Science Photo Library)
Alzheimer’s disease has destroyed neurons in the right-hand brain above.
(Credit: Jessica Wilson/Science Photo Library)

The Latest Insights—And The Future

Dr Emer MacSweeney told MedicalExpo e-magazine:

“Alzheimer’s Disease is a complex condition with multiple causes and will require more than one treatment. Much of the focus has been on anti-amyloid treatments, as the initial biomarkers detected toxic amyloid protein.

However, it is well recognized that the tau protein, which can now be detected and quantified with the help of biomarkers, is the toxic protein most closely correlated with symptoms and rate of progression of Alzheimer’s Disease.

Indeed, it is possible to have high levels of toxic brain amyloid protein without Alzheimer’s Disease symptoms, and if mildly symptomatic, this may not correlate with disease progression. As with all complex diseases, Alzheimer’s Disease treatment will evolve to personalized precision medicine, with multiple medications.”

Another key point of Dr MacSweeney’s lecture was the fact that the very definition of Alzheimer’s Disease has changed in the light of these recent scientific advances. She added:

“This condition should now be considered as a biologic entity defined entirely by amyloid, tau and new neurodegeneration biomarkers—irrespective of clinical symptoms or functional decline.

These biomarkers can be detected up to 20 years before the first symptoms. Therefore, in the future it should be possible to think of Alzheimer’s Disease as a preventable condition.”