Being Patient EIC Deborah Kan writes in from the 15th annual Clinical Trials on Alzheimer’s Disease (CTAD) conference in San Francisco.
Hello from the CTAD Alzheimer’s research conference in San Francisco, where I am attending this year’s meeting on the latest announcements on Alzheimer’s disease clinical trials. You might’ve heard the big news this week about pharma company Eisai’s lecanemab, the latest monoclonal antibody drug to reveal promising results at the conclusion of the phase 3 trial. Many of you have written to me asking what this all means, so I thought I would answer your questions here.
Remember when the HIV drug AZT was approved in 1987? It didn’t cure HIV or AIDS — but it did succeed in slowing the progress of the disease, prolonging lifespan. Similar to AZT, lecanemab was found to slow cognitive decline in people with Alzheimer’s by at least a little bit. Although difficult to understand what exactly that means in terms of quality of life, it does highlight the fact that the pathway for these monoclonal antibody drugs isn’t to cure Alzheimer’s, but rather to slow it down by preventing or dissolving beta-amyloid plaque in the brain. (Scientists still don’t know, by the way, if amyloid plaque is the correct target for solving Alzheimer’s.)
While I was catching up with my good friends’ Jim and Geri Taylor at the CTAD conference, Jim brought up a good point. Geri is living with Alzheimer’s disease and he believes that instead of cognitive measures, the real measure for drug efficacy is improving quality of life. ADLs or “activities of daily life” are usually included in the drug trial as a secondary outcome and the FDA approves drugs according to the primary outcome, which usually is cognition. Jim told me that what matters to him is how long Geri will be able to read, have conversations, dress herself and make a meal. And I have to say I agree. As I watch my mom descend into a later stage of Alzheimer’s, what I would give to have had the person she used to be just a little bit longer.
We will wait to see if the FDA approves lecanemab in early 2023. The even bigger question will be if it is covered by Medicare. Brace yourselves: We are entering another Alzheimer’s drug approval process!
