Experts outline changes needed to make the most of Alzheimer’s treatment breakthroughs
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A dementia expert at the University of Exeter is part of an international panel to outline thechanges needed to for people to get the greatest benefit from Alzheimer’s treatment breakthrough.
The approval of new antibody medications for Alzheimer’s disease – lecanemab and donanemab – and diagnostic tests in the blood mark the beginning of a new era in Alzheimer’s disease diagnosis and treatment.
However, Professor Clive Ballard is one of 40 leading Alzheimer’s disease experts to take part in The Lancet Series on Alzheimer’s disease. They warn that their potential will not be fully realized without rapid reform in healthcare systems, public policy, and societal attitudes, argue 40 leading Alzheimer’s disease experts involved in producing the Series.
Alzheimer’s disease accounts for about 70 per cent of all dementia cases and is a leading cause of disability, resulting in high societal and economic costs.
In a novel comparison, the Series highlights that the new monoclonal antibody treatments can slow Alzheimer’s disease progression to a level comparable to the efficacy of medicines for cancer, rheumatoid arthritis and multiple sclerosis. However, the authors say that differences in age, patient outcomes, and side effects mean such comparisons should be treated cautiously.
Despite the similarity in treatment effectiveness for other diseases, high costs of medication, complex testing requirements, suboptimal care for behavioural symptoms, and under-resourcing risk leaving people with Alzheimer’s behind.
Encouragingly, improvements in the prevention of Alzheimer’s disease are also on the horizon, with emerging Brain Health Services identifying people at a high risk for developing the disease and providing them with personalised treatment programs. Yet most cases of Alzheimer’s disease occur in people with low or normal risk, making population-wide measures which decrease risk – such as healthier urban design and restrictions on alcohol and sugary drinks – essential.
The authors call for coordinated global action so that the rapid pace of science advancement in the field of Alzheimer’s disease is matched by reforms at the level of healthcare providers, policy and society.
Professor Clive Ballard, of the University of Exeter Medical School, is one of just two authors in the series from the UK. He said: “It’s fantastic to see the major developments in diagnosis and treatment for people with Alzheimer’s disease over the last five years. However, we need widespread change to enable our clinical care systems to keep up with this progress, to deliver the best possible benefits to people with Alzheimer’s disease and their families.
Professor Ballard, who is also Dementia theme lead for the NIHR Exeter Biomedical Research Centre, said: “This Lancet paper is therefore a timely opportunity to summarize current knowledge and developments and give a much-needed clinical guide to treatment from disease modification in people at the earliest stages of pre-clinical Alzheimer’s disease, right through to individuals with more severe Alzheimer’s disease experiencing distressing psychiatric symptoms.”
Lead author of the Series, Professor Giovanni Frisoni, University of Geneva (Switzerland), says: “Blood tests, biological drugs for Alzheimer’s disease, and prevention interventions are propelling care into entirely new and exciting territory. However, the old needs of patients will not disappear. On the contrary, more general practitioners and dementia specialists will need to master the less glamorous but steady advances made in the past few decades in the care and treatment of behavioural disorders, the use of sophisticated diagnostic imaging and laboratory tools, and psychosocial care. A concerted societal effort in this direction will enable our current and future patients to benefit fully from the potential of scientific and technological advances.”
The publication is available here: https://www.thelancet.com/series-do/alzheimers-disease
