Neurologist: Alzheimer’s drug is ‘not the beginning of the end, but the end of the beginning’

Dr. Lawrence S. Honig is a neurologist at NewYork-Presbyterian/Columbia University Irving Medical Center. He is a professor of neurology at the Taub Institute for Research on Alzheimer’s Disease and the Aging Brain, and the Gertrude H. Sergievsky Center, where he directs the New York State funded Center of Excellence for Alzheimer’s Disease.  Honig was an investigator for the study that led to the FDA’s approval of Leqembi and has been an investigator for, received research funding from, and consulted for Eisai, the pharmaceutical company developing lecanemab, and other pharmaceutical companies. The opinions expressed in this commentary are his own. 

In early July, the US Food and Drug Administration granted traditional full approval of Leqembi (lecanemab-irmb) for the treatment of Alzheimer’s disease (AD). This is the first approved medication proven to slow the progression of AD’s clinical symptoms. A phase three trial among 50- to 90-year-old patients with early AD showed that it can do so by about 27% over an 18-month period. While we cannot extrapolate beyond 18 months, this represents about a six-month delay in progression of AD symptoms.

The drug functions by removing the amyloid beta protein that accumulates in the form of plaques in the brains of people with AD. A second disease-slowing drug, donanemab, has recently shown similar effects and may get FDA approval by the end of the year.

The development of Leqembi, building on two decades of research, is a notable success for medical science in that a disease previously impervious to any disease-modifying medical intervention now has an available, effective treatment. However, paraphrasing Winston Churchill, this is not the beginning of the end but the end of the beginning. The drug does not reverse disease symptoms or prevent progression, it slows progression. And there are considerations that make it inappropriate for many patients with AD.

It does, however, lay the groundwork for future AD medications that could alleviate suffering from this devastating disease for generations to come. [read more]
Source: CNN