A new era in Alzheimer’s treatment

Alzheimer's written in wooden cubes on a table

Contact: Will Sansom, 210-567-2579, sansom@uthscsa.edu

Statement from the Glenn Biggs Institute for Alzheimer’s and Neurodegenerative Diseases at UT Health San Antonio about a timely topic in the news:

The U.S. Food and Drug Administration on Friday, Jan. 6, 2023, approved lecanemab, a drug that targets the basic pathophysiology of Alzheimer’s disease. The FDA action is an “accelerated approval” of the drug, and the FDA requests continued diligent gathering of evidence on effectiveness and safety. A decision about full approval is a few weeks or months away and may be positive or negative. Regardless, the accelerated approval is a hopeful step forward.

Alzheimer’s therapies of the future will fall into two categories, those drugs that address the symptoms of Alzheimer’s such as forgetfulness without slowing the pathological changes in the brain, and drugs that will slow the progression of Alzheimer’s pathology in the brain. The second group are called disease-modifying therapies or DMTs. Lecanemab is the first DMT to demonstrate the slowing of Alzheimer’s disease convincingly in international prospective double-blind clinical trials. However, our enthusiasm is tempered by the fact that lecanemab is a drug with modest clinical effects but potentially serious adverse effects.

Presently lecanemab is only available through clinical trials. The possibility of lecanemab becoming available for regular clinical care will depend on the decision of the Centers for Medicare and Medicaid Services and insurance companies on whether to cover or to not cover the cost of the medication. That decision will be made later in the year. Meanwhile, the South Texas Alzheimer’s Disease Research Center (ADRC), a National Institute on Aging Center of Excellence in partnership with UT Rio Grande Valley, is a site of AHEAD, a human clinical research study of lecanemab. To maximize safety, the patient selection criteria are extremely rigorous. Only a few patients with early disease, minimal to no symptoms, and a low bleeding risk are eligible to receive the medication. Past studies of lecanemab have shown there is a risk of brain swelling and hemorrhage in more than 10% of patients. This must be closely monitored. The benefit of the drug therapy appears real but small (half a point on an 18-point scale of function) or equivalent to a few months slowing of disease progression.

We at the Glenn Biggs Institute and South Texas ADRC are closely monitoring all developments and will work with eligible patients to discuss if this option is suitable for them.

More information about the AHEAD study is available at the study page on the Glenn Biggs Institute website. This page contains a list of eligibility criteria and a YouTube video introduction to the study. To inquire about screening for the trial, contact Amy Saklad, director of research operations, at 210-567-8229 or saklada@uthscsa.edu.

The Glenn Biggs Institute for Alzheimer’s and Neurodegenerative Diseases is dedicated to providing comprehensive dementia care while advancing treatment through clinical trials and research. The Biggs Institute is a National Institute on Aging (NIA)-designated Alzheimer’s Disease Research Center (ADRC). In addition to patient care and research, the Biggs Institute partners with the School of Nursing at UT Health San Antonio to offer the Caring for the Caregiver program.

The University of Texas Health Science Center at San Antonio (UT Health San Antonio), a primary driver for San Antonio’s $44.1 billion health care and biosciences sector, is the largest academic research institution in South Texas with an annual research portfolio of $360 million. Driving substantial economic impact with its six professional schools, a diverse workforce of 7,900, an annual operating budget of $1.08 billion and clinical practices that provide 2.6 million patient visits each year, UT Health San Antonio plans to add more than 1,500 higher-wage jobs over the next five years to serve San Antonio, Bexar County and South Texas. To learn about the many ways “We make lives better®,” visit UTHealthSA.org.

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