New Alzheimer’s Drugs Offer Hope for Slowed Progression in Singapore
Singaporean authorities have approved two novel drugs, lecanemab and donanemab, to combat Alzheimer’s disease earlier in 2025, offering a potential turning point in the fight against the debilitating neurodegenerative condition. While not a cure, these medications represent a significant advancement by targeting the underlying mechanisms of the disease and slowing its progression, a condition that currently affects nearly 70 percent of dementia cases globally.
Understanding Alzheimer’s and the New Approach
Alzheimer’s disease is characterized by the accumulation of beta-amyloids – molecules that build up in the brain, specifically in the frontal cortex and hippocampus – disrupting normal brain function. The newly approved drugs are monoclonal antibodies, lab-produced proteins designed to mimic the body’s natural defenses by targeting and removing these harmful beta-amyloids. This approach differs significantly from existing treatments, which primarily focus on managing symptoms like memory loss and behavioral changes.
Lecanemab and Donanemab: Key Details
Lecanemab, marketed as Leqembi, is a product of Eisai, Biogen, and BioArctic. Donanemab, sold as Lormalzi in Singapore and Kisunla internationally, is developed by Eli Lilly. Both are administered via intravenous injection: lecanemab every two weeks for approximately 18 months, and donanemab every four weeks over the same period.
Clinical trials have demonstrated the efficacy of both drugs in slowing the disease’s progression. Published in the New England Journal of Medicine, findings from the lecanemab trial showed a slowing of decline by 27 to 37 percent in individuals with early-stage Alzheimer’s. A Phase 3 clinical trial of donanemab, published in the Journal of the American Medical Association, indicated a 20 to 29 percent slowing of cognitive decline.
“It works by clearing these protofibrils and amyloid plaques, which are believed to contribute to the progression of the disease,” explained a medical director from Eisai, referring to protein aggregates like beta-amyloids. Both drugs previously received approval from the US Food and Drug Administration (FDA) in 2023 and 2024 respectively, as well as from the Medicines and Healthcare products Regulatory Agency in Britain.
Singapore’s Approval and Access Considerations
The Health Sciences Authority (HSA) in Singapore confirmed the approval of both drugs earlier in 2025, but emphasized that they are prescription-only medications. “The treatment should be initiated by a physician experienced in the diagnosis and treatment of Alzheimer’s disease,” the HSA stated.
While initial experiences with lecanemab in Singapore have been largely positive, as reported by neurologists like Dr. Lee Kim En at Mount Elizabeth Hospital, potential side effects must be carefully managed. Common reactions include fever, body aches, and joint pains. More seriously, the drugs can cause amyloid-related imaging abnormalities (ARIA), leading to brain swelling or bleeding. “MRI monitoring is recommended during treatment to manage this risk safely,” cautioned a medical director.
Doctors are reporting positive outcomes. Dr. Lee, who has prescribed lecanemab to 27 patients, noted a slowing of disease progression and preservation of cognitive function in most cases, with only one patient experiencing mild, temporary confusion. Associate Professor Adeline Ng of the National Neuroscience Institute similarly observed that patients treated with lecanemab were able to maintain greater engagement with family and daily activities.
However, Prof. Ng stressed that these drugs are most effective in the early stages of Alzheimer’s and are not a curative solution, delaying progression by approximately six to eight months. She also noted that the drugs are not suitable for patients with a history of stroke or those taking blood thinners due to the increased risk of bleeding.
Cost and Future Outlook
A significant barrier to widespread adoption is the high cost of treatment. In the United States, lecanemab is priced at $26,500 (S$33,900) annually, while donanemab costs approximately $32,000 per year. Britain’s National Institute for Health and Care Excellence has declined to recommend routine use of either drug due to these costs and a lack of long-term data.
The pricing of the drugs in Singapore remains undisclosed, but the Ministry of Health is currently evaluating their clinical efficacy and cost-effectiveness to determine potential subsidies.
According to a senior official, the introduction of these drugs represents a “paradigm shift” in Alzheimer’s care, emphasizing the growing importance of early diagnosis and treatment, particularly given the region’s aging population. The availability of lecanemab may spur healthcare systems to adopt biomarker-based diagnostics and enhance infrastructure for safe infusion and monitoring, offering renewed hope for slowing disease progression rather than simply managing symptoms.
