In the last two years, the Food and Drug Administration approved two innovative Alzheimer’s medicines based on clinical trial results showing that both drugs reduced disease progression. Although some Alzheimer’s researchers welcomed the approval of lecanemab and donanemab, two antibody treatments that remove plaque-causing amyloid proteins from the brain, patient reactions have been inconspicuous.
According to doctors who treat people with Alzheimer’s, many patients had trouble understanding the implications of the clinical trial results, presented as a “percent decrease in the rate of cognitive decline,” for their own life.
To help patients and their families understand the effects of using the new Alzheimer’s drugs, researchers at Washington University School of Medicine in St. Louis have developed a method that makes the information easily accessible and comprehensible.
The study offers vital information that might assist patients and caregivers in balancing the advantages of treatment against its hazards and expenses. Alzheimer’s & Dementia: Translational Research & Clinical Interventions published the study [1].
Goal of the Study
The researchers estimated how many months of independent living an individual with Alzheimer’s should anticipate after receiving therapy by using the data about the disease’s natural history and the extent of the medications’ effects as established by clinical trials. The medication and the intensity of the patient’s symptoms at the start of treatment determined the benefits.
As a hypothetical example, a typical patient who began treatment with mild symptoms should expect to live independently for an extra 10 months if treated with lecanemab or eight months with donanemab.
Senior author Sarah Hartz, MD, Ph.D., a professor of psychiatry at WashU Medicine, stated that their goal was to figure out how to provide patients with information that was crucial to them and would assist them in making decisions about their care. Instead of an abstract figure like the percentage change in decline, people are more interested in knowing how long they will be able to live independently [2].
Alzheimer’s patients and their families face the difficult decision of whether to pursue a treatment that will not improve their condition or won’t even keep the symptoms from worsening.
Treatment with lecanemab or donanemab may, at most, reduce the inevitable cognitive loss associated with Alzheimer’s disease. In addition, treatment is costly, necessitates monthly or biweekly infusions, and involves dangers like brain swelling and bleeding, which are typically minor and resolve on their own but can occasionally be fatal.
However, just because the benefits are limited does not imply that they are not significant for patients and their families.
Independent Living with Alzheimer’s
The continuum between independence and reliance has two crucial turning points. The first is when a person’s capacity to perform daily activities like cooking, driving, paying bills, and keeping track of appointments deteriorates to the point that they are unable to live alone.
The second stage occurs when a person cannot care for their own body and needs support with showering, dressing, and toileting.
Hartz and colleagues initially evaluated when people could expect to lose each of the two types of independence if not treated to determine the impact of treatment. They examined the experiences of 282 research participants at the Charles F. and Joanne Knight Alzheimer Disease Research Center at WashU Medicine.
Although none of the participants had previously received the two new medications, they all met the treatment criteria. Additionally, the researchers computed the rate at which symptoms worsened without therapy.
The researchers used these independence and progression data, along with the documented effects of the two medications, to determine how long a person at each stage of the disease could expect to live or take care of themselves on their own without treatment, as well as how this progression would compare to those who received treatment.
An average person with very mild symptoms should expect to live independently for an additional 29 months without therapy, 39 months while taking lecanemab, and 37 months while taking donanemab.
Since the majority of individuals with mild symptoms, compared to those with very mild symptoms, were already incapable of living independently at baseline, the longer time they’d be able to take care of themselves was a more relevant statistic for them.
The researchers estimated that if lecanemab and donanemab were administered to a normal individual at this stage of the disease, they should expect to care for themselves independently for an additional 26 months and 19 months, respectively.
According to the authors, this method of understanding the medications’ impacts may enable patients and their families to make decisions regarding their care.
According to Hartz, the goal of this research is not to support or oppose these drugs. The study’s objective is to assist readers in making the best decisions for themselves and their loved ones by providing context for the effects of these drugs.
Alzheimer’s Research Association is a non-profit organization dedicated to helping caregivers of Alzheimer’s disease and dementia. We provide the latest information and news about the illness and helpful tips to help caregivers cope with their daily caregiving challenges. We realize the most important thing that a caregiver needs is financial assistance. Therefore, we provide grants to caregivers to ease their financial burden. Caregivers can apply for grants here: Alzheimer’s Grant Application.
You can also help caregivers in their endeavor by donating as much as possible: Donation To Alzheimer’s Research Associations.
