Donanemab: a promising trail of a new Alzheimer’s treatment, but no cure yet
An international trial of a new antibody drug, donanemab, has been shown to slow cognitive decline in people in the early stages of Alzheimer’s disease.
The latest results come from a phase 3 clinical trial involving 1,700 people with early symptomatic Alzheimer’s disease in Canada, the US, UK, Australia, Japan and Europe. A monthly infusion of the medication was shown to reduce cognitive decline by more than a third. In addition,:
- 47% of patients in the trial showed no decline on a key measure of cognition over the course of a year.
- 52% of patients in the trial were able to stop taking the medicine by one year, and 72% were able to do so by 18 months.
As Dr Susan Kohlhaas, executive director of research at Alzheimer’s Research UK explained:
“We’re now on the cusp of a first generation of treatments for Alzheimer’s disease, something that many thought impossible only a decade ago. People should be really encouraged by this news, which is yet more proof that research can take us ever closer towards a cure.”
What is donanemab?
Donanemab is a new antibody drug that slows cognitive decline by removing beta amyloid from plaque buildups in the brain of patients. Two previous drugs designed to treat those with Alzheimers, lecanemab (Leqembi) and aducanumab (Aduhelm) both received accelerated approval by the US FDA. Eli Lilly, the manufacturers of donanemab, is seeking that same approval in spring/summer 2023.
As Cathy Barrick, CEO of the Alzheimer Society of Ontario said:
“The United States has two approved treatments to slow progression of the disease, but currently Canada has none. (These) positive results give us hope that this may soon change. Our federal and provincial governments must get to work immediately to prepare for the arrival of new treatment options for Alzheimer’s disease.
Today’s results strongly suggest that donanemab must be administered early in disease progression to be effective … That means if and when these treatments become available in Canada, we will have to fundamentally and radically rethink how we detect and diagnose Alzheimer’s disease.”
However, as an article at Science.org points out, no new drug is without its risks:
“(The) preliminary donanemab results also reveal a sobering risk of brain swelling and hemorrhaging, side effects that … may be linked to two—perhaps three—deaths in the clinical trial and that echo hazards seen with lecanemab.”
Tau and tangles
Our understanding of Alzheimer’s and cognitive decline is expanding rapidly. That’s why the donanemab trial also looked at another brain protein, tau.
“Unlike beta amyloid, which forms plaques outside brain cells, tau malfunctions inside neurons, becoming enmeshed in clumps known as tangles. Their presence tends to indicate more advanced disease.”
Priorities for research into dementia
A study conducted by the Canadian Dementia Priority Setting Partnership asked Canadians what their priorities were for those undertaking dementia research. The resulting Top 10 Dementia Priorities included both medical and social aspects, and was topped not by the search for a new treatment, but more about the treatment of those with dementia by society:
- Addressing stigma
- Emotional well-being
- Impact of early treatment
- Health system capacity
- Caregiver support
- Access to information and services post-diagnosis
- Care provider education
- Dementia-friendly communities
- Implementation of best practices for care
- Non-drug approaches to managing symptoms
Home care for those living with dementia
At Vytality at Home, we offer home care services for those living with dementia. Our home care can provide the support and practical help those with dementia need to continue living in their own home for longer.
If you’re caring for someone with dementia, regular home care provision can help you too. Our expert caregivers can provide much-needed respite from caregiving, and give you time for yourself, knowing that your loved one is safe and well looked after. To discuss your home care requirements: