Alzheimer’s, a neurodegenerative disease that affects millions of people around the world, may experience significant changes in its approach thanks to a new amyloid drug, lecanemeb. To better understand how it works and what this advance represents, we spoke to Dr. Raquel Sanchez Del Valle, Coordinator of the Behavior and Dementia Study Group of the Spanish Society of Neurology.
What makes this medicine different?
“Alzheimer’s disease is characterized by, among other things A protein called beta amyloid accumulateswhich create thick and sticky plaques in the brain, as if they were fatty plaques that are difficult to dissolve,” explains Dr. Sánchez del Valle. This new treatment works directly on these plaques, clearing the brain of these protein clumps. “It is the first of its kind approved in the European Union. Unlike current over-the-counter treatments, which relieve symptoms such as memory loss or attention problems, This medicine attacks one of the main causes of the disease”, he added.
Although the disease is progressive, 27% less people who get it get worse at 18 months
A change in the course of Alzheimer’s?
According to Dr. Sanchez del Valle, this drug represents a New approaches to Alzheimer’s treatment, As it focuses on causes and not just consequences. “This drug has been shown to reduce the rate of deterioration in patients. Although the disease is progressive, Those who received it were 27% less likely to worsen at 18 monthsThat’s about 30% less than those who didn’t get it. This effect may be greater over time,” he elaborated.
However, Alzheimer’s is a complex and multifaceted disease. Although this drug solves the problem of amyloid beta, other factors are involved. “After beta amyloid accumulates, Another protein called tau accumulatesincluding inflammatory processes that contribute to neuronal death. Therefore, although reducing amyloid beta load is positive, Cannot completely cure or stop the disease”, he emphasized.
The European Medicines Agency advises against giving this drug to patients with two copies of the APOE4 gene, as the risks outweigh the benefits.
© Adobe StockWhat risks does this treatment involve?
As with any medical intervention, this medication has risks. “The most frightening is related to the process of eliminating beta amyloid plaques. When trying to eliminate them, Brain tissue can become irritated, causing inflammation or, in more severe cases, bleeding into the brain.”, explains the expert. These complications are usually detected on MRI scans, and although most patients do not have serious symptoms, it is important to monitor for potential adverse effects.
One factor that can affect the risks is Presence of the APOE4 geneA genetic variant associated with the metabolism of amyloid beta protein. “People with two copies of this variant have one Increased risk of brain swelling or bleeding. For this reason, the European Medicines Agency recommends not giving this drug to patients with two copies of APOE4, as the risk outweighs the benefit,” said Dr. Sánchez del Valle.
In Spain, approval of the drug will be slow because it depends on the Ministry of Health’s decision whether and under what circumstances it will be included in the national health system, which can take a year or more.
What does this mean for patients?
Before administering this treatment, a genetic study is required to identify the APOE variant. It guarantees the safe use of drugs by minimizing risks.
Although the drug has received a favorable recommendation from the European Medicines Agency, it is still Absent formal approval from the European Commission. Once approved, countries like Germany can start operating it immediately. “A In Spain, the process will be slow, since it depends on the decision of the Ministry of Health Whether it will be included in the national health system and under what circumstances, that may take a year or more,” he commented.
Therefore, there are possibilities, looking for immediate alternatives for family members Manage it privately in countries where it is already available. However, this implies estimating the full cost of treatment. In Spain, ways to accelerate access to medicines for the most needy patients are still being evaluated.
Lecanemeb is more effective at earlier stages, so the time between seeing a patient’s primary care doctor and being referred to a specialist should be shortened.
© Adobe StockWho could benefit the most?
“Evidence suggests that treatment in the early stages of the disease is most effective.”“Explained by Dr. Sanchez del Valle. However, the relationship with age is less clear. “Surprisingly, in research, Young people react worse, Probably because they were already at a more advanced stage of the disease,” he added.
A ray of hope for patients and their families
Although this is a new drug While this does not represent a cure for Alzheimer’s, it is an important advanceIt can significantly improve the quality of life of those who suffer from it. Addressing one of the root causes of the disease is a step in the right direction, and the ability to slow its progression gives hope to both patients and their families.
Alzheimer’s is a devastating disease, but “every advance, like this one, brings us a little closer to better understanding it and improving the care of those who suffer from it,” Dr. Sanchez del Valle concluded.
