New Alzheimer’s Drug: Donanemab

Context:

Within a year, a second drug has been found effective in checking cognitive decline in people with early Alzheimer’s. Developed by the pharmaceutical giant Eli Lilly, Donanemab was found to slow down cognitive decline by 35% when compared with a placebo in a phase III trial.

Relevance:

GS III: Science and Technology

Dimensions of the Article:

1. Key Findings of the Study on Alzheimer’s Drug
2. The findings are significant for several reasons
3. Alzheimer’s Disease

Key Findings of the Study on Alzheimer’s Drug:

Primary Endpoint Achievement:

• Over an 18-month period, the trial successfully achieved its primary endpoint of slowing cognitive decline in individuals with early Alzheimer’s disease.

Slower Cognitive Decline:

• Participants who received the drug experienced a 35% slower cognitive decline compared to those who received a placebo.

Preservation of Daily Functioning:

• The drug also demonstrated a 40% reduction in the decline of people’s ability to perform day-to-day tasks.

Impact on Intermediate and Advanced Disease Stages:

• The positive effects of the drug were observed in individuals with intermediate levels of tau protein, which correlates with the severity of Alzheimer’s.
• Surprisingly, even when the data of patients with high levels of tau representing the later stage of the disease were included, the drug still exhibited a meaningful impact on cognitive decline.
• Combining the results from both populations, cognitive decline was slowed by 22% within 18 months.

Significant Non-Decline Rate:

• Among those who received the drug, 47% did not experience cognitive decline, while only 29% of the placebo group showed no decline.

The findings are significant for several reasons:

Confirmation of a Leading Theory:

• The consecutive success of three therapies in slowing cognitive decline in patients with early Alzheimer’s provides further support for the theory that abnormal clumps of amyloid beta protein around brain cells are one of the main causes of the disease.
• This reinforces the understanding of Alzheimer’s pathology and could guide future research and treatment strategies.

Advancement in Understanding the Disease:

• The findings contribute to the ongoing efforts to understand the complex nature of Alzheimer’s disease.
• While the exact causes of Alzheimer’s are still debated, the success of these therapies adds weight to the amyloid hypothesis and strengthens the understanding of the disease’s underlying mechanisms.

Potential Treatment Breakthrough:

• The significant impact of the drug in slowing cognitive decline and preserving daily functioning represents a potential breakthrough in Alzheimer’s treatment.
• This offers hope to individuals diagnosed with early-stage Alzheimer’s and their families, as well as to healthcare professionals involved in their care.

Implications for Future Research:

• The findings create excitement and generate interest in further research on Alzheimer’s treatments.
• It highlights the need to explore and develop therapies that target the underlying causes and mechanisms of the disease.

Need for Long-Term Assessment:

• While the initial results are promising, the findings cover a relatively short duration of 18 months.
• Long-term assessment is necessary to understand how the disease progresses over extended periods and to evaluate the sustained effectiveness of the therapies.

Focus on Prevention:

• The high cost of therapies remains a significant barrier to access, underscoring the importance of prevention strategies for Alzheimer’s.
• The findings emphasize the need to prioritize efforts to prevent the onset of Alzheimer’s by addressing risk factors and promoting healthy lifestyles.

Alzheimer’s Disease

• Alzheimer’s disease is a chronic neurodegenerative disease that usually starts slowly and gradually worsens over time.
• It is the cause of 60–70% of cases of dementia.
• The most common early symptom is difficulty in remembering recent events.
• The cause of Alzheimer’s disease is poorly understood, about 70% of the risk is believed to be inherited from a person’s parents, with many genes usually involved.
• Other risk factors include a history of head injuries, depression, and hypertension.
• No treatments stop or reverse its progression, though some may temporarily improve symptoms.

How can Alzheimer’s be prevented?

• Lifestyle modifications that are known to reduce risks of other non-communicable diseases, like diabetes and hypertension, are also associated with a lower risk of Alzheimer’s.
• Doctors prescribe a healthy diet, exercising regularly, sleeping well, and reducing the risk of diabetes and heart disease. They also suggest stopping smoking and reducing drinking.
• Other than that, doctors suggest that people, especially the elderly and those with family history, should keep their brains active and engaged.
• Solving puzzles, learning new languages or new skills, and going out and making friends can all help.

-Source: Indian Express