Lecanemab: Is it praiseworthy or should we be concerned?

The MLK Pkwy-Orchard Lk is one of the most dangerous and accident prone intersections in the bay area with an average of 25 accidents/day. The municipal authorities introduced several safety measures as a result of which the daily average accidents reduced to 12/day. The authorities claimed success and declared that their safety programs were superior hence the rate of accident dropped. But to the general public and the logical people, the safety program only reduced the number of accidents but it did not completely eliminate the accidents nor did it make it any safer to drive in that area. So who is correct in their analysis, the civic authorities or the public? It depends on who you ask, but the picture is clear to any layperson-the safety measures did not eliminate the accidents to zero, it only reduced the daily average and the risk of getting involved in an accident still persisted.

A similar scenario is now playing in the pharma sector with respect to Alzheimer’s disease (AD). An experimental drug that removes a substance called amyloid from the brain appears to slow down Alzheimer's disease. The drug, Lecanemab, reduced the rate of cognitive decline by 27% in a study of nearly 1,800 people. Note, what was touted by the media as “a new drug shows promise” was not any improvement in patients with Alzheimer’s disease, nor even stabilization of the AD-associated symptoms. Simply put-the drug did not completely reduce cognitive decline, it only slowed down the rate of cognitive decline-similar to the traffic example I provided above. And just like the civic authorities who claimed victory, a cross section of scientists, clinicians and various associations claimed that Lecanemab was the best weapon to combat Alzheimer’s disease. Unfortunately, this vested group will not tell you that: 1)?about one in five people who got the drug experienced an adverse event, such as swelling or bleeding in the brain, 2)?people also reported symptoms including headaches, visual disturbances, and confusion, and 3)?the treatment was also linked to few deaths.

Even though the vested group claimed that these side effects are "mild to moderate," there is no doubt that the risks associated with this drug will definitely outweigh the benefits for a majority of the patients.? The design and mechanistic action of Lecanemab and other the drugs for Alzheimer’s that failed in the past are based on a misconception: removing beta-amyloid would ameliorate AD symptoms. This line of thinking is completely incorrect because even though the amyloid got reduced in most cases, cognition and other AD symptoms were not improved. In short, Lecanemab is more of an amyloid-reducing drug and less of an AD-modifying drug.

What we need is a AD-modifying drug/program that will completely stop the cognitive decline and reverse AD symptoms. This treatment methodology is the future—based on network analysis and systems-medicine and is akin to repairing a roof with numerous holes: the more holes you cover, the more success you have at fixing the problem, or in the case of the traffic example above, convert the accident prone intersection to the safest intersection to travel.?