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.”
On the grass outside the university library, it is as though it never happened.
The tents have been removed. The pavements have been sprayed. The graffiti removed.
Order and control have been restored. The protest has been silenced. For now at least.
A few streets away, at the university police station, an officer calls the names of the students arrested the night before.
On the steps in front of him, the bedraggled are waiting.
Pic: Reuters
Police clash with pro-Palestinian demonstrators on the UCLA campus early on Thursday morning. Pic: AP
Students, charged and released with a date in court, are here now to collect their belongings. They’re missing bags, belts, shoes, all lost in the chaos of the night before.
From the very heart of the protest encampment, our cameras had captured the chaos.
Officers moving in. Tear gas and rubber bullets to disperse. Stun grenades to disorientate.
Police detain a demonstrator, as they clear out the protest encampment in UCLA.
Pic: Reuters
They were scenes which have stirred an already fevered debate about Israel and Gaza, yes, but about much more too. About America, about policing, and about free speech too.
President Biden said yesterday: “Vandalism, trespassing, breaking windows, shutting down campuses, forcing the cancellation of classes and graduations – none of this is a peaceful protest.”
‘Wrong’ say the protesters. Their movement, they say, is the very essence of protest; of civil disobedience which is threaded through US college campus history.
Law enforcement official moves a tent at the protest encampment in support of Palestinians at the University of California Los Angeles (UCLA)
Signs of the days-long protest on campus being gradually cleared.
They reject any notion that they are threatening or violent. Yet the deeply divisive history of the Israel-Palestine conflict ensures that the beholder will so often be offended by the actions of the other side.
It was the students perceived antisemitism through their pro-Palestinian slogans which had drawn a group of pro-Israel protesters to the encampment earlier in the week.
The chaos of that night was reflected in a statement by the university’s student radio station which has been covering every twist.
This embrace turned out to be a thread of history
“Counter protestors used bear mace, professional-grade fireworks and clubs to brutalize hundreds of our peers, UCLA turned a blind eye. Police were not called until hours into the onslaught and stood aside for over an hour as counter-protestors enacted racial, physical and chemical violence,” the statement from the UCLA Radio Managerial team said.
Watching the clear-up after the nighttime police sweep of the protesters I spotted two people embracing. A young man and an older woman.
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Professor recalls violent arrest at protest
It turned out to be a thread of history. One was a student who’d been arrested the night before.
The other was a student from a past time. Diane Salinger had been at New York’s Columbia University in 1968, at protests which now form a key chapter in American history.
Diane Salinger had been at New York’s Columbia University in 1968, at protests which now form a key chapter in American history
“I’m so proud of these people here. I’m so proud,” she told me.
“You know the civil unrest of the students back in ’68 and it continued for several years, it actually changed the course of the Vietnam War and hopefully this is going to do the same thing.”
But then, back at the police station, a conversation that hints at the wider challenges for America.
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‘Tom’ is a protester who wanted to remain anonymous – a graduate who feels politically deserted in his own country. For him, no government is better than any on offer.
‘Tom’ is a protester who wanted to remain anonymous – a graduate who feels politically deserted in his own country.
“The problem with our system is that we can’t rely on the police, we can’t rely on the military to keep us safe.
“When we need to make our voices heard, we need to make them heard, and the only way to do that without being repressed is by keeping each other safe and I think that last night and the last few months have really exemplified that,” he told me.
These protests are about more than Gaza. They are aligning a spectrum of dissent.
A scuba dive boat captain has been jailed for four years for criminal negligence over a fire that killed 34 people.
Captain Jerry Boylan was also sentenced to three years supervised release by a federal judge in Los Angeles, California.
The blaze on the vessel named Conception in September 2019 was the deadliest maritime disaster in recent American history.
Boylan was found guilty of one count of misconduct or neglect of ship officer last year.
Captain Jerry Boylan. Pic: AP
The charge is a pre-Civil War statute, known colloquially as seaman’s manslaughter, and was designed to hold steamboat captains and crew responsible for maritime disasters.
In a sentencing memo, lawyers for Boylan – who is appealing – wrote: “While the loss of life here is staggering, there can be no dispute that Mr Boylan did not intend for anyone to die.
“Indeed, Mr Boylan lives with significant grief, remorse, and trauma as a result of the deaths of his passengers and crew.”
The Conception was anchored off Santa Cruz Island, 25 miles south of Santa Barbara, when it caught fire before dawn on the final day of a three-day voyage, sinking less than 30 metres from the shore.
Thirty-three passengers and a crew member died, trapped below deck.
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The victims included an environmental scientist, a Singaporean data scientist and a family of three sisters, their father and his wife.
Boylan jumped overboard, and four crew members who followed suit also survived.
The burned hull of the dive boat. Pic: AP
Boylan initially faced 34 counts of seaman’s manslaughter, meaning he could have faced a total of 340 years behind bars.
His lawyers argued the deaths were the result of a single incident and not separate crimes, so prosecutors instead charged Boylan with only one count.
While the criminal case has concluded, there are several ongoing lawsuits.
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