Hope on The Horizon for Alzheimer's and Dementia
In honor of Alzheimer’s Awareness Month, we wanted to write about something that should rightfully get your hopes up if you care for someone who is at-risk of battling Alzheimer’s.
For the estimated 6 million Americans living with dementia, new treatments through Amyloid-Targeting Therapies may prove to be a ray of hope. The recent approval of Lecanemab (Leqembi) and Donanemab (Kisunla) are two such therapies, developed through the latest research in Alzheimer's and Dementia research. But how do these drugs work, and are there other interventions that can prove hopeful? Here's what you need to know.
Understanding Lecanemab and Donanemab: Amyloid-Targeting Therapies
Both Lecanemab and Donanemab are drugs designed to destroy plaque in the brain known as amyloid plaques. These plaques are made of sticky proteins known as amyloid beta peptides that accumulate in the brain, eventually leading to cognitive decline and memory loss in people with Alzheimer's. By targeting and removing these plaques, the hope is that these drugs can slow down or even prevent the progression of the disease.
The Difference Between Lecanemab and Donanemab
Lecanemab and Donanemab work very similarly to each other. They both target the amyloid plaque build-up in the brain, but at slightly different timelines. The main differences between Lecanemab and Donanemab are:
- Lecanemab targets amyloid before it forms into plaques by targeting the amyloid beta peptides
- Donanemab targets existing amyloid plaques in the brain
- Lecanemab is administered intravenously every 2 weeks
- Donanemab is administered intravenously every 4 weeks
- The FDA approved Lecanemab for use on July 6, 2023.
- The FDA approved Donanemab more recently on July 2, 2024.
Fortunately, that's virtually where the differences end. Both are still highly effective at helping to slow down Alzheimer's in people with mild cognitive impairments. Both can also be given as IV solutions, although research is on the way to make these drugs deliverable by muscle injections. Doing so means that in-home care aids and staff at residential care facilities for the elderly (RCFEs) can possibly eventually this life-changing medication without the need for a hospital or doctor's visit.
How Do They Work?
Both Lecanemab and Donanemab enter the bloodstream via IV infusion therapy. Patients receive an infusion of Lecanemab every 2 weeks, and Donanemab every 4 weeks.
Lecanemab infusions usually last about an hour, with another hour for observation and to speak with a doctor. Donanemab infusions will last about 30 minutes, with another 30 minutes for observation.
At any time, if you experience symptoms like flushing, headache, chills, fever, or dizziness, your doctor will observe you and determine if your infusions can continue or need to be reassessed. Fortunately, most people only have mild symptoms after their first infusion, and can continue treatment if it's ok with their doctor.
Are Lecanemab and Donanemab Effective?
Research shows that both Lecanemab and Donanemab are effective at reducing the progression of Alzheimer's, and not by a small margin either. Donanemab, for instance, has been shown to slow down declining memory and thinking by roughly 35%. For people taking Lecanemab, this drug has been shown to slow Alzheimer's decline by 27% after 18 months of treatment, compared to people not taking the drug.
Both are highly effective and can be life-changing medications for people in the early and middle stages of Alzheimer's. Your doctor can determine if these drugs are right for you by first conducting an MRI or spinal tap to measure amyloid plaque build-up.
Increasing Accessibility to Alzheimer's Treatment
Currently, both Lecanemab and Donanemab are approved by the FDA and are available through IV treatment. However, their price can be steep, costing between $26,000 to $30,000 per year.
Thankfully, Medicare has stepped up to cover the cost of this Alzheimer's treatment. This has greatly increased the availability of these life-changing medications. Older people who are on fixed incomes can receive these infusions and still have more of their savings to spend on other senior living expenses, like comfortable residential care housing that offers memory care. While there is still a while to go for both of these drugs to be available for in-home settings, their FDA approval paves the way for new development and use.
Other Potential Interventions
While Lecanemab and Donanemab have shown promising results, not everyone is a good candidate for these drugs. They do increase the risk of issues like small brain bleeds and swelling, although further complications are rare. These drugs also aren't a good fit for people who are on blood thinners and have certain brain disorders.
Because of these risks, it's a good idea to keep in mind other interventions for Alzheimer's. New research shows that simple tasks, like recalling your evening autobiographically, can help enhance memory in older people with Alzheimer's. Behavioral interventions like tailored music intervention also helps reduce anxiety in people with dementia.
On the science forefront, scientists have discovered a molecule, DDL-920, which can potentially help improve cognition since it's helped mice in animal studies. All of these innovations are just a glimpse of what the future may hold for Alzheimer's treatment.
Keeping Hope Alive for Alzheimer's Treatment
Every day new clinical trials are being conducted to find a cure for Alzheimer's disease. Researchers are continuously exploring new treatments and interventions that can help slow down the progression of the disease and even prevent it from developing at all.
In the meantime, there are other highly effective treatments, like medication, memory care, and lifestyle changes, that can greatly improve the quality of life for those living with Alzheimer's. If you or a loved one are diagnosed with Alzheimer's, don't lose hope. There is still so much that can be done to manage the symptoms of Alzheimer's and dementia, ways to cope, and support available.