SCIENCE BEHIND THE NEWS: The newly approved Alzheimer’s may patients new hope, but it’s not without it’s danger.

The battle against Alzheimer’s disease is witnessing significant breakthroughs, with two promising drugs, lecanemab, branded as Leqembi, and another treatment candidate, donanemab, taking center stage. Developed by Eisai Co. Ltd in partnership with Biogen Inc., Leqembi recently received full FDA approval, providing newfound hope for Alzheimer’s patients and their families. The green light from the FDA has also unlocked Medicare reimbursement, thus facilitating broader access to the first drug proven to decelerate Alzheimer’s progression rather than merely alleviating its symptoms.

However, Leqembi’s road to patients is not without hurdles. The necessary extensive patient evaluations, regular infusions for drug administration, and vigilant monitoring for potential side effects present logistical and clinical challenges. Besides, the healthcare system must grapple with an inadequate number of trained doctors and insufficient infusion centers, which could hamper treatment delivery.

Leqembi is not a silver bullet against Alzheimer’s but it offers a significant advantage. It slows cognitive decline in early-stage patients, giving them an opportunity for a longer quality life with their loved ones. The treatment’s impact varies from patient to patient; for some, it could mean a few more months of managing daily tasks independently, while for others, the effect might be barely noticeable.

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Notwithstanding its benefits, Leqembi carries certain risks, including potential brain swelling or bleeding, conditions that one in five clinical trial patients experienced. This necessitates strict monitoring of patients and informed decision-making for those at higher risk, including those on blood thinners, those with a history of microscopic brain bleeds, and carriers of the APOE4 gene mutation.

Another factor adding to the complexity of adopting Leqembi is its financial burden. Despite Medicare covering 80% of the drug’s annual cost of $26,500, patients are left with significant out-of-pocket expenses. Co-payments may reach around $6,600, plus potentially tens of thousands of dollars for additional costs, such as medical visits and regular brain scans. Consequently, the total cost of treatment could soar to about $90,000 annually, resulting in nearly $18,000 in annual out-of-pocket costs for patients.

In the face of these challenges, it’s imperative that decisions about Leqembi’s use are made carefully. Prospective patients and their families must discuss the benefits and risks with medical professionals, understand their genetic risks through APOE4 mutation testing, and assess the logistical and financial implications.

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Meanwhile, the pharmaceutical industry is closely monitoring the FDA’s recent decision. It has put rival product donanemab under increased scrutiny, as investors and analysts eagerly await further information about its safety and efficacy. Amidst this dynamic scenario, Biogen’s stock has witnessed a modest rise, despite increasing competition for its products, signaling investors’ cautious optimism.

Like other investigational Alzheimer’s drugs, lecanemab is designed to target the disease process itself rather than merely addressing the symptoms. The hope is that such treatments might slow or even halt the disease’s progression. However, it’s important to note that, as of 2021, the clinical trial data for lecanemab and similar drugs has produced mixed results, and their long-term effectiveness and safety are still under investigation. Please consult the latest resources or a healthcare professional for the most recent information.

Lecanemab, also known as BAN2401, is a monoclonal antibody. Monoclonal antibodies are a type of biologic drug made from a type of white blood cell that targets a very specific area of a cell or molecule.

Specifically, lecanemab is an immunoglobulin G1 (IgG1) monoclonal antibody. It is produced in a lab by a single clone of cells (hence “monoclonal”) or a cell line with identical antibody molecules.

The target of lecanemab is the amyloid-beta (Aβ) protein, a key player in the pathogenesis of Alzheimer’s disease. Accumulation of these proteins in the brain leads to the formation of amyloid plaques, which are believed to cause neurodegeneration in Alzheimer’s.

The drug is designed to selectively bind to large, soluble Aβ protofibrils, which are an intermediate form between monomeric (single molecule) Aβ and insoluble Aβ fibrils that form plaques. By binding to these protofibrils, lecanemab helps to inhibit their growth and disrupts the formation of toxic aggregates, facilitating their clearance from the brain.

Leqembi’s FDA approval marks a significant milestone in Alzheimer’s treatment. It offers hope to millions of patients, tests the healthcare system’s capacity to handle such advanced treatments, and influences the pharmaceutical market dynamics. As such, it is an exciting, albeit complex, development in the ongoing quest to combat Alzheimer’s disease.

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