Recent developments in drug research for Alzheimer’s disease offer potential for slowing the progression of the illness among patients in the UK.
Next year, individuals in Britain may experience a significant medical advancement. They could potentially be granted access to the initial medications created to delay the effects of Alzheimer’s disease.
The first of these medicines – lecanemab – was recently approved in the US and Japan, where treatments using it have already been launched. A second drug, donanemab, is expected to follow soon, and next year it is anticipated that the UK medical authorities will consider both of them for approval in Britain.
There is optimism that scientists are making progress in finding solutions to the dementia crisis in the UK. Currently, there are around one million people living with this condition, and it is projected to increase to 1.7 million by 2040, which could have devastating effects. In 2020, dementia claimed the lives of 66,000 individuals in England and Wales, making it the top cause of death in Britain, with Alzheimer’s responsible for two-thirds of cases.
Previously, physicians were limited to prescribing medications that aided in managing symptoms. Therefore, the introduction of the initial medicines that address the root cause of the ailment has been positively received. However, professionals have cautioned that their usage should be approached with care.
David Thomas, the head of policy at Alzheimer’s Research UK, stated that the latest medications can delay the progression of Alzheimer’s for six months to a year. However, they are only beneficial for individuals in the early stages of the disease and should not be considered as miracle cures.
“After years of study, they have achieved the first direct improvement in patients’ lives, which is certainly a reason for celebration. At the very least, this indicates that we are likely headed in the right direction when it comes to addressing Alzheimer’s.”
Neurologist Cath Mummery, from the Dementia Research Centre at University College London, supported this idea. She expressed that it has been a challenging journey, but they are finally able to see something promising. This is greatly appreciated.
The development of Alzheimer’s disease is caused by the accumulation of amyloid protein in the brain. However, symptoms may not manifest until decades after this buildup has begun. For over two decades, researchers have been attempting to prevent the formation of these plaques in hopes of halting the advancement of the disease.
Lecanemab and donanemab, developed by Eisai in Japan and Eli Lilly in the US, are the initial medications to successfully slow down the progression of this disease. However, they do not fully stop its advancement.
Next year, both medications will be evaluated for approval in the United Kingdom. The MHRA will assess their safety and effectiveness, followed by Nice’s evaluation on their cost-effectiveness.
Both medications are costly, with lecanemab priced at approximately $25,000 (£19,700) per year. They are administered through regular intravenous infusions. Thomas noted that this poses a challenge for health services, as it requires finding the necessary space and time to treat individuals in an infusion suite.
One of the primary challenges for doctors is accurately identifying dementia, both in its initial and advanced stages. Typically, patients first visit their general practitioners, who then refer them to memory clinics for diagnostic testing. Unfortunately, there are often significant wait times for these appointments, averaging around two years.
Furthermore, the process of identifying Alzheimer’s and other types of dementia typically involves administering written examinations, followed by lumbar punctures and brain imaging tests to confirm a diagnosis.
Approximately 65% of instances are verified using this method. The remaining 33% of dementia cases go undiagnosed. However, patients can only anticipate receiving treatments, such as the new medications, if their condition is detected.
Eleanor Mackenzie-Smith’s father, Mike, was diagnosed with young-onset Alzheimer’s 17 years ago when Eleanor was 11 years old. It took over a decade and four different tests from 2009 to 2017 for Mike to receive his final diagnosis at the age of 65. The uncertainty and lack of understanding during this time was heartbreaking for Eleanor and her family. Sadly, many other families have also experienced the same struggle of watching their loved ones suffer from dementia without a clear diagnosis or access to proper treatment.
Graeme Armstrong’s experience sheds light on the difficulties faced by patients. In 2006, his wife Trina began experiencing difficulty recognizing faces and reading phone numbers. After a CT scan three years later, she was told that she may have suffered a stroke, even though her symptoms did not align with this diagnosis. It wasn’t until three more years had passed that she was diagnosed with posterior cortical atrophy, a rare form of Alzheimer’s disease that impacts the brain’s ability to process visual information.
“If Trina had received an accurate diagnosis four years ago, she could have been prescribed the correct medication. This could have potentially been more effective and improved her daily life,” stated Armstrong.
Doctors are currently searching for a solution involving blood tests that can accurately and promptly identify the disease. According to Thomas, these tests are still being researched and it will likely be several years before they are widely available. In the meantime, it is important to improve the organization and focus of the NHS in order to achieve earlier and more accurate diagnoses of dementia, which will greatly aid in the fight against the condition.
Mummery concurred, stating that it takes approximately 20 years for Alzheimer’s disease to develop in the brain before symptoms of dementia appear. Therefore, it is crucial to detect warning signs at an earlier stage in order to diagnose individuals and potentially treat the disease before it progresses. This means being able to identify subtle symptoms that may be present in the very early stages of the disease.
Our current service is not suitable for this task, and we must create brain health clinics that can detect the disease at an earlier stage and provide support in building resilience against dementia for patients in the early stages.
Over time, researchers have identified several recent advancements that offer promise in addressing dementia in a more targeted and efficient manner. A significant obstacle they have encountered is the difficulty of delivering drugs past the blood-brain barrier, which regulates the transfer of ions and molecules between our bodies and brains. This poses a challenge in treating issues like amyloid plaques in the central nervous system.
Mummery stated that scientists are currently working on techniques for transporting drugs through the blood-brain barrier. One approach being investigated is finding ways to improve the efficiency of drug delivery into the brain, which could potentially have significant effects.
Scientists warn that it will take several years for these advancements to come to fruition, and there is a significant amount of work that must be done immediately to address dementia.
Thomas stated that although progress has been made, there is still much work to be done in addressing the processes affecting our brains. He acknowledged this as a significant challenge.