The brain scan of a patient affected by Alzheimer’s disease.Alzheimer’s disease is one of the most intractable problems in modern medicine; the last few decades have seen a steady drumbeat of seemingly promising treatments for the debilitating illness that eventually came to nothing. So when thelast week, it was major news — particularly because unlike its controversial predecessor Aduhelm, Lecanemab appears to yield real benefit in patients.
Certainly, it differs from Aduhelm, the drug that the FDA infamously approved two years ago against the recommendation of one of its own councils and an independent panel. There was ainto that approval process, which found that the drugmaker, Biogen, which also co-developed Lecanemab, was overly cozy with the FDA. Do you trust that the agency did the right thing this time?
What this indicates to me is that, yes, Abeta plaques play a role in the disease, and we have to consider them in any kind of treatment. But clearly, they alone are not responsible for the progression of the disease, because if they were, this drug would have halted progression, which it didn’t. It halted it in a statistically significant way, but a 27 percent decrease in the rate of decline is not a major effect.
I think certainly some companies will try something else. They employ a lot of really smart people and a lot of people who truly care for patients. It’s not that they only want to make money. They actually do want to help. I fear, however, that some companies, at least, will also be narrowly just trying to develop better Abeta antibodies thinking that maybe this just isn’t good enough. You could argue that, well, you cleared all the plaques, but there’s still a tiny bit left.