REASON FOR CAUTION While the approval of these drugs is exciting, “it is still early and we need to know the long-term risks and benefits,” says Hausknecht. Lecanemab is only approved for
people with early Alzheimer’s or MCI. It does not cure the disease, it only slows it down, and it can’t reverse brain cell loss that has already occurred. “The drug is given by infusion
every two weeks over one hour. The most common side effects are allergic- type reactions or flu-like symptoms that are tolerable. “The downside is a complication
called ARIA [amyloid-related imaging abnormalities],” says Hausknecht. ARIA is temporary brain swelling
or small brain bleeds that may cause headache and dizziness, and in rare cases more serious side effects, including seizures, that may be life- threatening. “If picked up quickly, the
“Leqembi is the first drug fully
FDA-approved in the history of Alzheimer’s to modify the disease process. All previous drugs just reduced symptoms,” explains Hausknecht. The FDA approved another
anti-amyloid antibody drug last month — Eli Lilly’s donanemab, branded as Kisunla, which has shown similar results. A panel of independent advisers endorsed the drug’s safety and effectiveness in June. “Up until now most people diagnosed with Alzheimer’s often wait for medical attention and frequently have more advanced disease at presentation, so the people who could benefit are a minority of the patients, unless we start to recognize the milder symptoms and make the diagnosis earlier,” notes Hausknecht.
medication can be stopped until ARIA resolves or stabilizes, and the complication is manageable,” says Murman. The FDA approval calls for caution
in anyone taking a blood thinner, which is common in people over age 65.
WHAT ABOUT COSTS? One year of treatment with lecanemab is expected to cost $26,000-$27,000 per year for the drug, plus the costs associated with the infusions,
brain MRI scans, and extra follow- up clinic visits. Before someone can go on the
drug, they must be tested to show they have brain amyloid. This includes a brain imaging
study, called a PET amyloid scan, and a sample taken from cerebrospinal fluid (spinal tap) to look for amyloid proteins. A blood test for the APOE4 gene variant is available. These diagnostic tests are also
expensive. Both Medicare and Medicaid have said they will cover some or all of the costs, but the details still need to be worked out.
EARLIER DIAGNOSIS HELPS In the past, when there was no way to slow down Alzheimer’s, diagnosing it at the earliest possible time was not a major concern. With the possibility of a disease- modifying treatment, the race to find an earlier diagnosis has become a very big focus. “A simple blood or spinal fluid
test to diagnose early Alzheimer’s has been an elusive goal for many years,” says Hausknecht. New guidelines for diagnosing Alzheimer’s disease at an earlier stage were recommended at the Alzheimer’s Association International Conference. These include use of a simple
blood test that can find proteins in the blood years before plaques become visible on a PET scan, even before symptoms develop. The blood test is as accurate as
the more expensive diagnostic tests and is expected to be approved in the next two years for diagnosis. Imagine a time when you notice
the earliest signs of MCI, like taking longer to remember a name or another “senior moment,” and a simple blood test could diagnose Alzheimer’s before plaques develop. In that time, an anti-amyloid
antibody could be started to stop Alzheimer’s in its tracks.
AUGUST 2024 | NEWSMAX MAXLIFE 79
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LEQEMBI.COM
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