While researchers continue to work on a full cure for Alzheimer’s disease, they’re finding treatments that can help manage symptoms and delay their onset, including the recently approved next-gen therapies lecanemab and donanemab.
Both treatments have been approved by US regulators in the last couple of years, and they work by clearing out some of the amyloid protein plaques in the brain that are linked to Alzheimer’s. However, there’s some debate over how effective they are.
To quantify the effectiveness of lecanemab and donanemab in more meaningful terms, researchers from the Washington University School of Medicine (WashU Medicine) recruited 282 volunteers with Alzheimer’s, analyzing the impacts of taking these drugs over an average of nearly three years.
“What we were trying to do was figure out how to give people a piece of information that would be meaningful to them and help them make decisions about their care,” says Sarah Hartz, a professor of psychiatry at WashU Medicine.
“What people want to know is how long they will be able to live independently, not something abstract like the percent change in decline.”
The researchers measured two different types of independence: being able to live with day-to-day responsibilities (so dealing with appointments and bills, for example), and being able to care for yourself alone (for instance, the basics of washing and dressing).
Those with very mild Alzheimer’s symptoms, who may have difficulty remembering dates and medications, would live independently for another 29 months without treatment on average, the estimates showed.
A person with this same level of dementia could expect around 10 additional months of independence on lecanemab and 13 months of independence on donanemab, the estimates suggest.
However, it’s important to note that these figures are averages, and different patients have different responses to these drugs.
“My patients want to know, how long can I drive? How long will I be able to take care of my own personal hygiene? How much time would this treatment give me?” says Suzanne Schindler, a physician and a professor of neurology at WashU Medicine.
“The question of whether or not these drugs would be helpful for any particular person is complicated and has to do with not only medical factors, but the patient’s priorities, preferences and risk tolerance.”
It’s important to mention that these therapies come with downsides too: they’re expensive, require regular infusions, and can lead to potentially dangerous side effects such as brain swelling and brain bleeds.
Those with Alzheimer’s and their families therefore need to weigh up the potential pros and cons – and the possible implications later in life.
“The purpose of this study is not to advocate for or against these medications,” says Hartz. “The purpose of the paper is to put the impact of these medications into context in ways that can help people make the decisions that are best for themselves and their family members.”
The research has been published in Alzheimer’s & Dementia: Translational Research & Clinical Interventions.
