New Alzheimer’s drug slows progression, but not cure

Dear Dr. Roach:The U.S. Food and Drug Administration has granted traditional approval to Leqembi (lecanemab) for the treatment of early-onset Alzheimer’s disease. Although it is not yet a cure, it appears to slow the progression of symptoms. Since treatment must be started early in the course of the disease, should older people like me (77 years old) undergo some form of screening for Alzheimer’s disease? This could detect the disease before the patient, their family and their doctor realize it, so that treatment could be started as soon as possible.

DS, MD

Dear DS, MD:Lecanemab is a new treatment for Alzheimer’s disease. It is a monoclonal antibody against amyloid protein. Amyloid protein is found in the brains of people with Alzheimer’s disease, and it is speculated that amyloid protein may be part of the underlying cause of Alzheimer’s disease, although a second protein, tau , can also play a role.

There is considerable interest in lecanemab since a 2023 trial showed that it slowed the worsening of cognitive loss compared to a placebo. Lecanemab essentially stopped the deposition of amyloid protein, even reducing the amount present in the brain.

There are some important caveats. The first is that the drug, administered intravenously twice a month, is only indicated in people with proven presence of amyloid protein in the brain and who suffer from early Alzheimer’s disease or mild disorders. cognitive according to formal tests. It should not be used in people who have no symptoms or who have advanced dementia.