Lecanemab: New Alzheimer’s drug slows decline in memory – fuelling hope doctors will one day cure dementia
Doctors have hailed a “new era” of medicine after a study showed for the first time that a drug can slow the debilitating symptoms of Alzheimer’s.
Results from the clinical trial also revealed that the drug lecanemab cleared clumps of a protein called amyloid – thought to be a key cause of the most common form of dementia – from patients’ brains.
The data, published at a conference in San Francisco, led to an outpouring of optimism from scientists, many of whom had spent decades trying to understand what leads to the disease and find a treatment.
Rob Howard, professor of old age psychiatry at University College London, said the results were “wonderful and hope-filled” – adding: “At long last we have gained some traction on this most terrible and feared disease and the years of research and investment have finally paid off.
“It feels momentous and historic. This will encourage real optimism that dementia can be beaten and one day even cured.”
The manufacturers of the drug released top-line results in a news release earlier in the autumn, but many doctors held back from celebrating until full results were released at the Clinical Trials on Alzheimer’s Disease conference.
They showed that lecanemab slowed the decline in memory and mental agility by 27% in patients with mild Alzheimer’s.
‘Doctors are optimistic’
Critically, the drug removed so much of the amyloid protein that the patients wouldn’t have had enough evidence of Alzheimer’s disease on their brain scans to actually qualify for entry to the trial.
The study strongly suggests that the drug only starts to have a clinical effect once amyloid is reduced to low levels in the brain.
Results after 12 months of treatment suggested it was ineffective – but after 18 months, the effect was significant.
Doctors are optimistic that continued treatment will lead to even better results.
Professor Nick Fox, director of the Dementia Research Centre at University College London, said: “It confirms a new era of disease modification for Alzheimer’s disease, an era that comes after more than 20 years of hard work by many, many people, with many disappointments along the way.”
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Lecanemab is not a cure. But even slowing the progression of Alzheimer’s disease would be game changing, delaying the need for specialist care and allowing people to spend more time with their families.
However, the drug has side effects.
One in eight patients given lecanemab suffered brain swelling and other changes, probably as a result of removing the amyloid protein. But most only had evidence of problems on brain scans. Fewer than one in 30 had actual symptoms such as headaches or confusion.
Some patients had bleeding in the brain, though deaths were no higher in those receiving treatment than those given a dummy drug.
Nevertheless, it underlines the need for careful monitoring of those on treatment.
Prof Fox said: “Any risk is clearly important, but I believe that many of my patients would be very willing to take such a risk.
‘Massive challenge for the NHS’
Doctors warned that lecanemab will be a massive challenge for the NHS, not just because the drug is given through an intravenous infusion every two weeks.
Most Alzheimer’s patients are currently diagnosed when they have moderate symptoms – too late for treatment with lecanemab. And just 1% have their diagnosis confirmed by a brain scan or lumbar puncture, a biopsy of their spinal fluid.
Susan Kohlhaas, director of research at Alzheimer’s Research UK said: “It’s safe to say that the NHS is not ready for a new era of dementia treatment.
“We estimate that unless there are drastic changes in how people access specialist diagnostic tests for Alzheimer’s disease, only 2% of people eligible for drugs like lecanemab will be able to access them.”
Until now there have only been drugs that treated symptoms rather than the underlying cause. But if lecanemab is licensed for use on the NHS then delays in treatment will result in brain cells dying and the disease progressing.
Prof John Hardy, from the UK Dementia Research Institute in London said the drug had been “a long time coming”.
He added: “I truly believe it represents the beginning of the end.
“The first step is the hardest, and we now know exactly what we need to do to develop effective drugs. It’s exciting to think that future work will build on this, and we will soon have life-changing treatments to tackle this disease.”
The overnight events do not reflect well on President Biden.
He had signalled so emphatically just days ago for Israel not to retaliate.
“Take the win,” the American president told Israeli Prime Minister Benjamin Netanyahu in the early hours of Sunday morning.
Middle East latest – follow live
Benjamin Netanyahu has ignored Biden’s pleas. Pic: Reuters
It was a message made public and combined with back-channel briefings we were getting from the White House and the State Department.
Washington’s message to the Israeli government was that the spectacular failure of the Iranian attack, combined with the diplomatic first of having the Jordanians and the Saudis defending Israel, was a victory.
“Take it, don’t retaliate,” was the message they hoped would land. Uncontrolled escalation is just too much of a risk.
But Israel has been ignoring America for a few months now. Biden has frequently found the limits of his influence over Gaza.
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‘Blasts’ seen in sky above Iran – reports
As this week progressed, it became clear that on this issue too Netanyahu wasn’t going to be bent by Washington, London or anywhere else.
And there were plenty who questioned the wisdom of Biden’s diplomatic directive.
Israel had just faced the biggest aerial assault in its history by a nation committed to its destruction.
“Take the win”?! Really? To many, it sounded like an astonishing appeasement of Iran.
And so, as it dawned on diplomatic visitors to Israel this week that Netanyahu and his war cabinet were going to ignore Biden and hit back, the language began to shift.
“Don’t retaliate” became “minimise escalation”.
“We hope they do so in a way that does as little to escalate this as possible,” UK Foreign Secretary David Cameron said after meeting Netanyahu on Tuesday.
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Cameron: Israel’s response ‘should be smart’
My understanding is that Western diplomats were given a heads-up by Israel that it was hitting back overnight and with some detail on the type and location of the targets.
But this past week raises questions about the Biden administration’s influence and its strategy.
Biden’s call for no retaliation was very public and echoed by allies. It was driven by the real fear of uncontrolled escalation.
But was it diplomatically smart to make the call so public? Some are asking if that didn’t just undermine Israel’s ability to reestablish deterrence.
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Privately call for restraint, maybe. But why publicly?
But more than that, did the public “don’t do it” messaging just expose President Biden to failure and weakness when his directive was simply ignored by Israel?
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Brace now for the next move.
Perhaps a steady de-escalation through a series of strikes on targets each less significant than the one before it – both sides saving face, both claiming deterrence.
Such is the madness of conflict.
Donald Trump described the hush money case against him as a “mess” after the jury who will decide his fate has been selected.
Leaving the court in New York after proceedings were adjourned for the day, Trump addressed reporters, saying he was supposed to be in states like Georgia, New Hampshire and North Carolina as part of his campaign for the 2024 presidential election.
“[But instead] I’ve been here all day,” he said, labelling the trial as “unfair”.
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Trump held up a stack of news stories and editorials that he said were critical of the case while he continued railing against the trial.
“The whole thing is a mess,” he said.
It comes as all 12 jurors have been seated in the first criminal case against a former US president.
Pic: AP
Members of the jury include a sales professional, a software engineer, an English teacher and multiple lawyers.
Sky News’ US partner network, NBC News reported there are seven men and five women on the jury.
It comes after lawyers grilled hundreds of potential jurors asking questions on everything from their hobbies and social media posts to their opinion of the former president.
More than half of a second group of prospective jurors were dismissed by Judge Juan Merchan on Thursday after most said they doubted their ability to be fair and impartial.
One juror was also dismissed after she said she “slept on it overnight” and woke up with concerns about her ability to be fair and impartial in the case.
The challenge now is to select six alternate jury members before the trial can move to opening statements, with Mr Merchan hopeful this will be completed on Friday.
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Trump is accused of criminally altering business records to cover up a $130,000 (£104,200) payment to adult film actress Stormy Daniels, real name Stephanie Clifford, during his 2016 election campaign.
Ms Daniels and former Playboy model Karen McDougal, who was paid $150,000 (£120,000), both claim to have had affairs with Trump.
Stormy Daniels. Pic: AP
His lawyers say the payment was meant to spare himself and his family embarrassment, not to help him win the election.
Trump faces 34 felony counts of falsifying business records. He could get up to four years in prison if convicted.
The former president faces two other criminal trials accusing him of trying to subvert his 2020 election loss to Joe Biden, and another that accuses him of mishandling classified information after he left the White House in 2021.
He has pleaded not guilty to all charges against him.
The world’s first known combat between a human pilot and a fighter jet controlled by AI has been carried out in California, the US military has said.
In a drill over Edwards Air Force Base, the pair of F-16 fighter jets flew at speeds of up to 1,200mph and got as close as 600 metres during aerial combat, also known as dogfighting.
One was manned, while the other jet was a modified version of the F-16, called the X-62A, or VISTA (variable in-flight simulator test aircraft).
The AI-run plane in action. Pic: Kyle Brasier/USAF
While in flight, the AI algorithm relies on analysing historical data to make decisions for present and future situations, according to the Defence Advanced Research Projects Agency (DARPA), which carried out the test.
This process is called “machine learning”, and has for years been tested in simulators on the ground, said DARPA, a research and development agency of the US Department of Defense.
In 2020, so-called “AI agents” defeated human pilots in simulations in all five of their match-ups – but the technology needed to be run for real in the air.
Pilots were on board the X-62A in case of emergency, but they didn’t need to revert controls at any point during the test dogfight, which took place in September last year and was announced this week.
The result represents a “transformational moment in aerospace history”, DARPA said in a statement.
It did not reveal which aircraft won the dogfight.
The two planes near each other during the drill. Pic: DARPA/YouTube
“The potential for autonomous air-to-air combat has been imaginable for decades, but the reality has remained a distant dream up until now, said Secretary of the Air Force Frank Kendall.
“In 2023, the X-62A broke one of the most significant barriers in combat aviation. This is a transformational moment, all made possible by breakthrough accomplishments of the X-62A ACE team.”
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Colonel James Valpiani, a commandant at the US Air Force test pilot school. said: “Dogfighting is a perfect case for the application – machine learning.
“Dogfighting is extremely dangerous. So, if machine learning can operate effectively in an environment as dangerous as air-to-air combat, it has great potential to earn the trust of humans as we look to applications that are less dangerous but equally complex.”
He added: “The X-62A is an incredible platform, not just for research and advancing the state of tests, but also for preparing the next generation of test leaders.
“When ensuring the capability in front of them is safe, efficient, effective and responsible, industry can look to the results of what the X-62A ACE team has done as a paradigm shift.
“We’ve fundamentally changed the conversation by showing this can be executed safely and responsibly.”
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