After the accelerated approval granted by the US Food and Drug Administration (FDA) for a drug to treat Alzheimer’s disease developed by Biogen and Eisai, named lecanemab, there has been another entry in the field of Alzheimer’s treatment. Eli Lilly, a pharmaceutical company, has introduced its candidate Alzheimer’s drug, donanemab, further expanding the prospects in Alzheimer’s treatment scenario.
Understanding Donanemab and Lecanemab
Donanemab is an antibody-based therapy that belongs to a class of treatments targeting amyloid-beta (Aβ) proteins that form amyloid plaques in the brain, causing cognitive decline. By aiming to eliminate these plaques, donanemab seeks to decelerate the progression of the disease. In contrast, lecanemab is part of a class of drugs known as monoclonal antibodies, which also target beta-amyloid and impair cell function.
Safety Concerns Surrounding the New Treatments
Both donanemab and lecanemab carry a significant risk of side effects including amyloid-related imaging abnormalities (ARIA), such as brain swelling or bleeding. During the trials of donanemab, three patients tragically lost their lives due to these side effects.
Exploring Alzheimer’s Disease
Alzheimer’s disease is a progressive neurodegenerative disorder affecting the brain, resulting in memory loss, cognitive decline, behavioral changes, speaking or writing difficulties, poor judgment, personality changes, and confusion about time and place. It is the most prevalent cause of dementia, accounting for 60-80% of dementia cases globally.
Causes and Risk Factors of Alzheimer’s
While the exact cause of Alzheimer’s is still unknown, several contributing factors have been identified. Age is the primary risk factor, with most cases found in individuals over 65. Genetic mutations, such as those in the APP, PSEN1, and PSEN2 genes, have been linked to an increased risk of developing Alzheimer’s. Further, the disease is thought to be triggered by the abnormal build-up of amyloid-beta and tau proteins in and around brain cells. Lifestyle factors such as cardiovascular disease, diabetes, obesity, smoking, and a sedentary lifestyle may also contribute to the risk.
Diagnosis and Treatment
The diagnosis process involves cognitive and neuropsychological tests to assess memory, thinking, and problem-solving abilities. It also incorporates imaging techniques (MRI, PET scans) to identify brain changes and biomarker tests (cerebrospinal fluid analysis, amyloid PET) to detect amyloid plaques. While there is currently no cure for Alzheimer’s disease, supportive therapies and medications can temporarily alleviate symptoms.
Prevalence of Alzheimer’s
Alzheimer’s disease affects a significant number of people worldwide, with at least 55 million individuals suffering from the condition. In India, with its ageing population, the number of people with dementia and Alzheimer’s is projected to rise to 7.6 million by 2030.
Unpacking Dementia
Dementia is broadly defined as a decline in cognitive abilities severe enough to interfere with daily functioning. It is currently the seventh leading cause of death and one of the major causes of disability and dependency among older people globally.
