After more than twenty years without therapeutic developments against Alzheimer’s, a new drug has been recommended in Europe for a certain group of patients in the early stages of this neurodegenerative disease. How does the medicine work? How to select candidates? What side effects can it cause? Challenges and keys to the active ingredient lecanemab.
Alzheimer’s is the most common form of dementia and it is estimated that there are more than 800,000 cases in Spain, although 30-40% may go undiagnosed, according to data from the Agency Spanish Society of Neurology (SEN), Therefore, lecanemab may open a door to hope for a disease for which there is no cure yet.
This neurodegenerative disease affects 10% of people over the age of 65 and 30% of those over the age of 85, although it can appear much earlier.
“The accumulation of amyloid protein in the brain is considered the initial and fundamental phenomenon in Alzheimer’s disease, although it is not the only one,” explains EFEsalud. neurologist Raquel Sánchez del Valle, coordinator of the Study Group on Behavior and Dementia of the Spanish Society of Neurology (SEN).
This concentration of proteins causes a type of plaques in the brain and this drug “mobilizes the immune system to dissolve and eliminate them,” says the neurologist.
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What is lecanemab?
- The active ingredient lecanemab is a monoclonal antibody addressed against amyloid protein which accumulates in the brain, is an anti-amyloid therapy that reduces the plaques that form.
- Him trade name It is called Leqembi and was developed by the biopharmaceutical companies Eisai (Japanese) and Biogen (American).
- Him scope of lecanemab is to slow down the progression of Alzheimer’s from its initial stages.
- Effectiveness: In 18-month clinical trials, the lecanemab group was shown to reduce disease progression by 27%.
- I am administration It is administered intravenously, in hospital, every two weeks and it is yet to be established how long it can be extended for, for now it is 18 months, as the study has shown.
- Los side effects of this targeted therapy can be: inflammation of the brain and hemorrhage, which is technically called “air”.
Which Alzheimer’s patients are candidates for lecanemab?
- Addressed to newly diagnosed patients at an early stagewith memory problems or mild dementia but with practically normal functionality or who need some little help but are independent to be able to go out, do the shopping, get dressed or eat… About a third of the diagnoses are in the initial phase, explains the doctor, which warns of the risk of underdiagnosis in these early stages.
- In addition to being in the early stage, those affected must have done so one or no copies of the ApoE4 gene (gene associated with a higher risk of developing Alzheimer’s). This is 85% of patients.
- If excludes patients with two copies of the ApoE4 gene due to the increased risk of serious side effects. 15% of Alzheimer’s patients have these two copies of ApoE4.
- For the patient selection It is necessary to confirm that they have amyloid pathology in the brain and this can be done through a lumbar puncture of the cerebrospinal fluid or a PET scan and genetic testing to determine the number of copies of the ApoE4 gene. MRI is required before and during treatment to monitor the risk of side effects.
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Straight
- Following the official recommendation of the European Medicines Agency (EMA), the Spanish Agency for Medicines and Health Products must do so authorize the use of the drug in Spain.
- The next step is whether it will be funded by the National Health Systemas requested by various patient associations, since it is an expensive medicine. In the United States, the price has been set at around $26,000 per year per patient (two vials per month), explains the neurologist.
- Distribute selection and treatment programs of patients, taking into account the importance of identifying the early stages of Alzheimer’s, “one of the challenges of these drugs”, concludes the neurologist from SEN Raquel Sanchez del Valle.
What are the key benefits of lecanemab for early-stage Alzheimer’s patients?
Time.news Interview: Editor In Conversation with Dr. Raquel Sánchez del Valle on Lecanemab and Alzheimer’s Treatment
Editor: Good morning, Dr. Sánchez del Valle. Thank you for joining us today to discuss the recent advancements in Alzheimer’s treatment, particularly the newly recommended drug, lecanemab. After more than two decades without any therapeutic developments, what does the approval of this drug signify for patients?
Dr. Sánchez del Valle: Good morning, and thank you for having me. The approval of lecanemab is a monumental step in the field of neurology and for Alzheimer’s patients. For years, we have been in dire need of effective treatments to address this devastating disease. Lecanemab offers a new avenue of hope, especially for those diagnosed early, who often face a grim future with limited options. It represents progress in our approach to not just manage symptoms but to slow the progression of the disease itself.
Editor: That’s an encouraging perspective. Can you delve a bit deeper into how lecanemab works? What is its mechanism of action?
Dr. Sánchez del Valle: Certainly! Lecanemab is a monoclonal antibody that targets amyloid protein, which accumulates and forms plaques in the brains of Alzheimer’s patients. The accumulation of this protein is a key hallmark of the disease. What lecanemab does is work with the immune system to mobilize it to dissolve and eliminate these plaques, thereby potentially slowing down disease progression.
Editor: That sounds promising! What criteria are used to select candidates for this therapy? Not everyone diagnosed with Alzheimer’s can be treated with lecanemab, correct?
Dr. Sánchez del Valle: That’s correct. Lecanemab is primarily aimed at newly diagnosed patients in the early stages of Alzheimer’s, particularly those who are experiencing mild dementia but still maintain a degree of independence. It’s crucial that candidates have either one or no copies of the ApoE4 gene, which is associated with an increased risk of the disease. About 85% of Alzheimer’s patients fall into this category. Those with two copies of the ApoE4 gene are excluded from treatment due to the heightened risk of severe side effects.
Editor: Speaking of side effects, what are some of the risks associated with lecanemab?
Dr. Sánchez del Valle: Like any targeted therapy, lecanemab has potential side effects. The most significant include inflammation of the brain, a condition termed ARIA, and hemorrhage. Patients will undergo regular MRI scans before and during treatment to monitor for these risks. While the side effects are a concern, it’s important to weigh them against the potential benefits in slowing the disease’s progress.
Editor: It sounds like a thorough selection process is in place to ensure patient safety. Can you explain the administration process for lecanemab?
Dr. Sánchez del Valle: Lecanemab is administered intravenously every two weeks, usually in a hospital setting. The current protocol suggests treatment for a duration of 18 months, as indicated by clinical trials. However, we are still determining long-term administration strategies.
Editor: With over 800,000 Alzheimer’s cases estimated in Spain alone, how critical is awareness and early diagnosis in this context?
Dr. Sánchez del Valle: It’s incredibly important. Given that 30-40% of Alzheimer’s cases may go undiagnosed, there’s a pressing need for increased awareness among both the public and healthcare professionals. Early diagnosis not only allows patients to access treatments like lecanemab sooner but also enables them and their families to plan for the future.
Editor: Thank you, Dr. Sánchez del Valle, for these insights. It seems there is a new wave of hope for Alzheimer’s patients, and your expertise illuminates the importance of continued research and patient care in this field.
Dr. Sánchez del Valle: Thank you for having me. I hope that with further research and the continued development of treatments like lecanemab, we can significantly alter the landscape of Alzheimer’s treatment for future generations.