Revolutionary Medications Poised to Transform Dementia Care

Scientists at Tufts University have made an amazing breakthrough. They’ve discovered that a medication named Donanemab could revolutionize the treatment for Alzheimer’s patients. This medication could potentially be accessible in Canada and the United States within the next two years, pending the availability of clinical trials in these countries.

Donanemab has demonstrated encouraging outcomes in clinical trials. It seemed to reduce the deterioration of cognitive function in the brain by 35 per cent compared to a placebo. This was observed in a phase three clinical trial involving 1,182 individuals with early-stage disease. The medication also resulted in a 40 per cent slower decline in the ability to carry out daily tasks.

Produced by Eli Lilly, Donanemab targets the brain “plaque” associated with Alzheimer’s disease. The treatment significantly diminished the plaque as early as six months post-treatment. While the results were highly promising, scientists noted that Eli Lilly had only released the “headline findings” of that trial. They would need to see more detail in the full results to get a clearer idea of how revolutionary the medication will prove to be. Eli Lilly plans to disclose the complete data from the trial shortly.

The cost of the medication, estimated to be around ￡20,000 (approximately $26,000 USD or $33,000 CAD), may be considered too high by healthcare systems like the NHS. However, for those who can afford it, once any medication is approved by regulators, they would be able to obtain it privately.

Another hopeful medication, Lecanemab, created by Eisai and BioArctic, was found to slow the progression of the disease by 27 per cent in an advanced phase three trial last year. Like Donanemab, Lecanemab works by breaking down amyloid, a toxic protein that can accumulate in the brain in plaques.

Both medications are administered in a similar manner, through intravenous infusions every four weeks for up to 18 months. Researchers believe that by clearing amyloid plaques from the brain, anti-amyloid medications will be able to slow down the progression of Alzheimer’s disease.

While both medications are promising, experts warn that the two-year prediction for their availability is an optimistic scenario. It could take longer or not happen at all if, for instance, the regulator decides the potential side effects outweigh the benefits.

Both Lecanemab and Donanemab can cause a condition known as amyloid-related imaging abnormalities, or Aria. Problems include brain swelling and brain haemorrhages, or brain bleeds, that in the case of each medication are thought to have contributed to a few deaths of patients in trials. Despite these challenges, the future of dementia treatment appears promising. With ongoing research and development, we may soon have more effective treatments for this devastating disease.

A Personal Perspective: Living with Dementia for Two Decades.................

From my personal experience of living with this disease for 20 years, from diagnosis to the end of life with my mother, I’ve gained some insights.

While current medications target the plaque that accumulates in the brain, they do not repair already damaged neurons. I concur that something is better than nothing given the limited availability of medication. However, the side effects of these medications, even the already approved ones, can sometimes outweigh the benefits of managing an already challenging disease. For instance, my mother developed seizures from Memantine. This was not just a significant side effect; it led to other concerns. Even after discontinuing the medication, she continued to have seizures until the end of her life. This is something to consider when deciding whether to use these drugs, especially the newly approved ones.

Here’s a thought: since Dementia can be asymptomatic for as much as 10 years prior to symptoms, shouldn’t we be more proactive for those who have dementia in their families by ensuring preventative measures? For a disease that cannot be quantified with the financial, emotional, and mental costs associated with it, we should be more prudent about prevention. Once diagnosed, without an effective treatment, we still don’t have an answer to the root cause of the disease. According to Alois Alzheimer, more than 100 years ago, it could only be studied post-mortem. This disease is devastating, and one only truly understands it once you or your loved one is diagnosed. By then, you are already 10 years behind. I hope I live to see the day when there is a cure, remission, or prevention. For me, prevention is my only hope.