DREAMS of a cure for dementia are closer than ever thanks to breakthrough trial results confirmed last week.
There are an estimated 900,000 people in the UK living with dementia and there is no cure or effective treatment.
The main cause is Alzheimer’s disease, which accounts for two in three cases. In September, scientists proved for the first time that they can tackle it using a drug designed to clear damaging protein clumps from the brain.
The drug, named Lecanemab, reduced progression of dementia by 27 per cent over 18 months.
It is the first proof that using drugs to clear the clumps — made up of a protein named amyloid — can slow the disease.
Although this is not a cure, the discovery gives a huge boost to hopes for future treatments.
Dr Mark Mintun, vice-president of brain diseases at US pharmaceutical firm Eli Lilly told Sun Health: “This is a new era in Alzheimer’s disease . . . we’re going in the right direction.”
Vicious cycle
It was Professor John Hardy, a scientist at University College London, who 30 years ago came up with the theory of how the build-up of amyloid protein triggers Alzheimer’s.
His team suggested sticky lumps of the protein start a vicious cycle, in which the immune system makes the brain damage worse.
It was Professor John Hardy, a scientist at University College London, who 30 years ago came up with the theory of how the build-up of amyloid protein triggers Alzheimer’s.
His team suggested sticky lumps of the protein start a vicious cycle, in which the immune system makes the brain damage worse.
Speaking in November, Professor Hardy called this “a historic moment”.
The biggest success of 2022 — and arguably decades of dementia research — was the Lecanemab trial, revealed by manufacturers Eisai and Biogen.
Eli Lilly’s drug, Donanemab, also showed in a trial that it was able to partly clear amyloid protein from the brain.
That study, presented at the Clinical Trials on Alzheimer’s Disease conference in San Francisco last week, revealed 37.9 per cent of patients had “clearance” of the protein after six months.
On average, scans showed the drug removed two thirds of the amyloid in the subjects’ brains.
A larger trial, set to end next summer, hopes to prove this will prevent the patients’ symptoms of dementia, as Lecanemab did. But this effect is not a given, and other, very similar amyloid-busting drugs have failed.
One made by Roche, was one of this year’s biggest disappointments.
Trials found small reductions in amyloid and brain decline, but the company said they were “not statistically significant”. Despite coming so close to success, Roche has now abandoned the drug.
Millions of people in the UK and worldwide are forced to watch their loved ones decline, knowing doctors can do nothing.
Destruction of vital nerves in the brain means patients suffer memory loss, confusion, physical disabilities, personality changes, mental health problems and eventually death.
Although trial successes bring hope, the benefits of first-generation drugs are likely to be small.
Dr Mintun said: “For example, if we had a 32 per cent slowing of disease that could mean, over an 18-month period, the person has saved six months of progression.
“So whatever they would have stopped being able to do over the next six months, they will still be able to do.
There may also be serious side-effects, such as increased risk of stroke or brain swelling. At least two patients in the trial of the successful drug Lecanemab have died, including a 65-year-old woman of stroke. An 80-year-old reportedly died in June.
Getting access to the new therapies will not be easy either.
Professor John Hardy said he hoped the first patients in the UK will gain access to Lecanemab by the end of next year but they will probably be private patients, as the drugs are expected to be very expensive because they have cost so much to develop.
UK experts fear the NHS is not geared up to prescribe a completely new type of drug to such a large group of patients.
More stretched
Also, the medicines will work best if they are given in the very early stages of Alzheimer’s, ideally before symptoms begin.
But these patients are extremely difficult to diagnose, because testing for the condition is expensive and complicated — at a time when the NHS is more stretched than ever.
There are also more than 300,000 people with other types of dementia, which the drugs are not designed for.
The Department of Health and Social Care last week confirmed its commitment to the Dame Barbara Windsor Dementia Mission taskforce, while Boris Johnson’s government committed to doubling dementia research funding to £160million per year by 2025.
Dr Susan Kohlhaas, director of research at Alzheimer’s Research UK, said: “The road to an anti-amyloid treatment has been a long one.
“We hope that this drug will make it to patients, but it won’t be suitable for everyone with Alzheimer’s. It’s only a first step on the journey towards a cure.”
‘Bittersweet news for me and my dad’
CLARE O’Reilly, 43, from Plymouth, is hopeful for the future, despite the fact that dad Mick, 75, from Solihull, West Mids, is living with dementia and Alzheimer’s.
She says: “It’s bittersweet news because it’s too late for my dad, there’s only one way his condition is going to go, but the thought my three children may have hope should I ever be diagnosed is some thing I’m incredibly grateful for.”
Mick says: “Knowing if Clare gets Alzheimer’s she could get treatment is nothing short of miraculous.
“It’s a lonely diagnosis. I wouldn’t want her to have the thoughts I’ve had, and the confusion.”
‘I’m at high-risk so this gives me hope’
SOPHIA HUSBANDS, 43, from Windsor, Berks, who runs a wellness brand, fears she will develop Alzheimer’s after her parents were both diagnosed.
Her father died, aged 75, and her mother lives with the condition.
Sophia says: “You feel as if you are losing someone, even though they are still alive. Mum is only 78 and her health is declining.
“I’d love for there to be better treatments for her but I worry about my own future too.
“I’m probably at high risk, given that both my parents have been diagnosed.
“It’s great to know so many treatments are being discovered and so many trials are being done.
“It gives me hope.”
