Treating Alzheimer's disease early offers better hope of slowing decline, study finds

Trial of experimental drug donanemab found it slightly slowed deterioration in memory and thinking and worked better in patients at an early stage and in those under 75 years of age.

Treating patients with Alzheimer's disease as early as possible - when symptoms and brain pathology are mildest - offers a better chance of slowing the decline cognitive, according to a large study of an experimental Alzheimer's drug presented on Monday suggests.

The study of 1,736 patients reported that the drug, donanemab , made by Eli Lilly, may slightly slow the progression of memory and thinking problems in the early stages of Alzheimer's disease, and that the slowdown was greatest for early-stage patients when they had less than a protein that creates tangles in the brain.

For people in this early stage, donanemab seemed to slow decline in memory and thinking about four months and half to seven and a half months over an 18-month period compared to those taking a placebo, according to the study published in the journal JAMA. Among people with less of the protein, called tau, the slowdown was most pronounced in those under 75 and those who didn't yet have Alzheimer's but had a pre-Alzheimer's condition called mild cognitive impairment. , according to data presented at the Alzheimer's Association International Conference in Amsterdam on Monday. 'have already declined and are on that steep slope," Dr. Daniel Skovronsky, medical and scientific director of Eli Lilly, said in an interview.

“No matter how you cut the data – earlier, younger, milder, less pathological – every time, it seems that early diagnosis and early intervention are the key to managing this disease,” a- he added.

The findings and recent approval of another drug that modestly slows decline in the early stages of Alzheimer's disease, Leqembi, signals a potentially promising turning point in the long and difficult road to finding effective drugs for Alzheimer's disease, a brutal disease that afflicts more than six million Americans. Donanemab is currently under review for approval by the Food and Drug Administration.

Donanemab and leqembi (also known by the scientific name lecanemab) do not have not been directly compared to each other in research studies. The individual trials of the two drugs differ in design and other aspects, making it difficult to say which drug might be more effective.

Each drug has risks important safety concerns, especially swelling and bleeding in the brain, which, although often mild, can be serious in some cases. The donanemab trial had higher rates of swelling and bleeding than the Leqembi trial, but comparisons are difficult due to patient differences and other factors.

No drug reverses or repairs brain damage already caused by disease. Many Alzheimer's disease experts therefore see them as just a first step in a potentially fruitful direction. more data,” three geriatricians wrote in an op-ed published Monday in JAMA.

Three deaths were linked to donanemab in its clinical trial, the study reported. Three Leqembi trial participants also died, after suffering brain swelling and bleeding. But Eisai, the Japanese company that makes Leqembi with Boston-based Biogen, said it was unclear whether the drug contributed to those deaths because those patients had complex medical conditions.

Both drugs attack another protein, called amyloid, which clumps together in...