Explained | Will we defeat Alzheimer's? Why new trial with 60% success is a beacon of hope

What can be called a massive breakthrough in the field of fightingAlzheimer's, a research saidMonday (July 17) that an experimental medicine from Eli Lilly works best if Alzheimer's patients are treated as early as possible with it.

The research, published in JAMA, emerged as a new ray of hope for all those who are suffering from this condition. It says that the medication would ideallyhelp before patients develop symptoms of the brain-wasting disease.

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This is the latest promising development for treating the most common form of dementia. Alzheimer's is a type of dementia that affects the brain. It slowly destroys memory and thinking skills and the ability to carry out the simplest tasks in day-to-day life.

The new trial data was presented at the Alzheimer's Association International Conference in Amsterdam. It stated that the medicine, Donanemab, has been shown to slow the progression of memory and thinking problems by about a third. However, the rate doubles to 60 per cent if it is started when patients are only mildly impaired.

There's no cure for Alzheimer's or any disease-modifying treatment, but Donanemab has shown positive results in its first trials. The research included over 1,700 patients, and a comprehensive analysis of the trial revealed that results were less robust for older, later-stage individuals, as well as those with greater levels of tau, a protein linked to Alzheimer's disease progression.

Anne White, who is the president of neuroscience at Lilly, said that the findings highlight that "earlier detection and diagnosis can really change the trajectory of this disease".

Company awaits FDA approval

The medicine has not been approved yet, as Lilly expects the US Food and Drug Administration todetermine whether to approve Donanemab before the end of this year. The company said that the submissions to additional global regulators are underway and that the majority will be finished by the end of the year.

This medication is like the recently approved Eisai and Biogen drug Leqembi, which is an injectable antibody designed to remove deposits of a protein called beta-amyloid from Alzheimer's patient's brains.

Dr Susan Kohlhaas, who is the executive director of research and partnerships at Alzheimer's Research UK referred to Lilly's data released on Monday, and said that "these results provide further confirmation that removing amyloid from the brain can change the course of Alzheimer's, and may help people affected by this devastating disease if they're treated at the right time."

Are we winning against Alzheimer's?

The result is promising, and millions of people who are struggling hope to make their lives better. Maybe not fully, but to help them partially as the brain disorder due to Alzheimer's gets worse over time.

While dealing with Alzheimer's, what's important first and foremost is to raise awareness and address the common stigma that surrounds disease-related dementia.

A World Health Organization (WHO) published earlier this year in March mentioned that more than 55 million people have dementia worldwide currently, over 60 per cent of whom live in low-and middle-income countries. Every year, there are nearly 10 million new cases.

Dementia is caused by a number of diseases and traumas to the brain and Alzheimer's disease is the most common type of dementia, accounting for 60-70 per cent of cases.

Dementia is now the seventh largest cause of death and one of the primary causes of impairment and dependency among the world's elderly, WHO said.

Maybe we are not winning, but even a positive breakthrough can be massive for those who are losing cognitive functioning and behavioural abilities.

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Are there side effects?

Lilly's research states that brain swelling, a recognised side effect of amyloid-clearing antibodies, occurred in more than 40 per cent of Alzheimer's patients.

According to the company, brain swelling affected 24 per cent of the entire Donanemab treatment group. Brain haemorrhage occurred in approximately 31 per cent of the Donanemab group and around 14 per cent of the placebo group.

According to the researchers, the medication was connected to the deaths of three study patients.

The study investigator Dr Liana Apostolova, who is a professor in Alzheimer's Disease research at Indiana University School of Medicine, said that "these side effects should not be taken lightly," but most cases were manageable by monitoring with magnetic resonance imaging (MRI) or stopping the medicine.

She said that doctors are likely to use "very stringent MRI safety screening while we treat these patients".

Donanemab's treatment impact increased relative to the placebo during the duration of the 18-month trial, according to Lilly, even for patients who were taken off the drug after their levels of amyloid deposits dropped dramatically.

Meanwhile, White said that "at the end of the trial, the average patient had been without drug for seven months and yet they continued to benefit." She said the findings support the idea that Donanemab can be stopped once amyloid is cleared from the brain.

Dr Liz Coulthard, an associate professor in dementia neurology at the University of Bristol, said, "Some patients did not worsen significantly during the trial and on the average progression of disease was slowed 4.4-7.5 months over 18 months."

Despite the side effects, some are hopeful. Dr Reisa Sperling, who directs the Center for Alzheimer Research and Treatment at Brigham and Women's Hospital in Boston, said that the latest study "gives me great hope" for the outcomes of those prevention trials.

(With inputs from agencies)

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