After more than twenty years of lack of therapeutic development against Alzheimer’s disease in Europe, a new drug has been recommended for use in a selected group of patients in the early stages of this neurodegenerative disease. How does the medicine work? How to select candidates? What side effects can this cause? Problems and clues to the active ingredient lecanemab.
Alzheimer’s disease is the most common form of dementia and it is estimated that there are more than 800,000 cases in Spain, although 30-40% may be undiagnosed, according to Spanish Society of Neurology (SEN), Thus, lecanemab could open the door to hope for a disease for which there is still no cure.
This neurodegenerative disease affects 10% of people over 65 and 30% of people over 85, although it can appear much earlier.
“The accumulation of amyloid protein in the brain is considered the initial and fundamental phenomenon in Alzheimer’s disease, although it is not the only one,” explains EFEsalud. neurologist Raquel Sánchez del Valle, coordinator of the behavior and dementia group of the Spanish Society of Neurology (SEN).
This concentration of protein causes plaque to form in the brain, and this drug “mobilizes the immune system to dissolve and eliminate it,” the neurologist says.
What is lecanemab?
- Active ingredient: lecanemab monoclonal antibody addressed against amyloid protein which accumulates in the brain is an anti-amyloid therapy that reduces the amount of plaque that forms.
- He trade name This is Leqembi, developed by the biopharmaceutical companies Eisai (Japanese) and Biogen (American).
- He target The goal of lecanemab is to slow the progression of Alzheimer’s disease from the early stages.
- Efficiency: In an 18-month clinical trial, the lecanemab-treated group showed a 27% reduction in disease progression.
- His administration It is given intravenously in hospital every two weeks and is yet to be determined how long it can be extended, currently 18 months, the study found.
- side effects From this targeted therapy there may be: inflammation of the brain and bleeding, which is technically called “aria”.
Which patients with Alzheimer’s disease are candidates for treatment with lecanemab?
- Addressed newly diagnosed patients at an early stagewith memory problems or mild dementia but with essentially normal functions, or who require little assistance but are unable to go out, shop, dress or eat on their own… About a third of diagnoses are in the early stages, explains the doctor who warns about the risk of underdiagnosis in these early stages.
- In addition to being at an early stage, victims must have one or no copies of the ApoE4 gene (gene associated with a higher risk of developing Alzheimer’s disease). This is 85% of patients.
- HE excludes patients with two copies of the ApoE4 gene. due to an increased risk of serious side effects. 15% of Alzheimer’s patients have these two copies of ApoE4.
- For patient choice The presence of amyloid pathology in the brain needs to be confirmed and this can be done through a lumbar puncture of the cerebrospinal fluid or a PET scan and genetic tests to determine the copy number of the ApoE4 gene. MRI is necessary before and during treatment to monitor the risk of side effects.
Problems
- Following the official recommendation of the European Medicines Agency (EMA), the Spanish Medicines and Health Products Agency should authorize the drug for use in Spain.
- The next step is whether it will funded by the NHSas required by various patient associations since it is an expensive medicine. In the US, the price is set at about $26,000 per patient per year (two bottles per month), says the neurologist.
- Implant selection and treatment programs patients, taking into account the importance of detecting Alzheimer’s disease in the early stages, “one of the problems with these drugs”, concludes SEN neurologist Raquel Sánchez del Valle.