New promising treatments for Alzheimer’s disease may not be as beneficial for black and Hispanic sufferers, according to a recent report by Reuters. Leqembi and donanemab, experimental antibodies developed by pharmaceutical companies Eli Lilly and Eisai, are the first drugs that may slow the effects of the fatal disease by targeting and attacking the buildup of toxic plaques in the brain. However, older black Americans and Hispanics, who have higher rates of dementia than white people, were often excluded from clinical testing for these medications.
The issue lies in the screening process for clinical trials. Prospective black and Hispanic volunteers who displayed early symptoms of Alzheimer’s didn’t have enough amyloid in their brain to qualify for the trials, as reported by 10 leading Alzheimer’s experts. This disparity was more pronounced for black people, with five of the researchers noting the issue.
Dr. Crystal Glover, a health equity in aging researcher at the Rush Alzheimer’s Disease Center in Chicago, questioned the relevance of the new treatments for the groups that are most at risk. Japanese pharmaceutical company Eisai, which developed Leqembi with American partner Biogen, expressed its concern over the screening process, as 49% of black volunteers did not meet the amyloid threshold requirements for the trial, compared to 22% for whites and 55% for Hispanics.
Out of the 947 people enrolled in the US portion of the trial, only 4.5% were black, while Hispanics comprised 22.5%. Ivan Cheung, outgoing senior vice president at Eisai, emphasized that people who are amyloid positive should receive Leqembi regardless of their race or ethnicity, stating that the drug was not designed to help specific ethnic groups.
Blacks and Hispanics were also excluded at slightly higher rates for testing of Eli Lilly’s donanemab. A spokesperson from Lilly suggested that the participants’ dementia may not be caused by Alzheimer’s or that their illnesses are complicated by other factors, such as small strokes.
According to the Alzheimer’s Association, an estimated 6.7 million Americans aged 65 and older are living with Alzheimer’s. Among black Americans aged 70 and older, 21.3% have the disease. The current challenges in ensuring equitable access to new Alzheimer’s treatments highlight the need for more inclusive clinical trials and research efforts.