A new drug recently approved by Health Canada is giving hope to patients with early Alzheimer’s disease by targetting an underlying cause of the disease rather than just managing symptoms.
For people with mild cognitive impairment or mild dementia caused by early Alzheimer’s, lecanemab (sold under the brand name Leqembi) will not stop the disease from progressing, but it has been shown to delay its progress for around one year.
That may not seem like a long time, but for anyone who has lost a loved one to Alzheimer’s, any amount of extra time is valuable, said Pam Morley Cooke.
Morley Cooke lost her mother to the disease, and she now volunteers making fidget aprons for people with dementia in the Windsor-Essex area.
“It would be such a huge benefit for the family and the patient to prepare themselves,” she said, recalling how quickly her mother’s symptoms progressed, and how hard it was on the family.
Any extra time is valuable, according to Pam Morley Cooke, who lost her mother to Alzheimer’s disease. (Submitted by Pam Morley Cooke)
Lecanemab is a disease-modifying drug that targets and removes beta-amyloid, a protein that can build up in the brain as a plaque, leading to cognitive decline. It has already been approved in more than 50 countries and regions, including the United States and Europe.
A new breakthrough in Alzheimer’s treatment is great to see, Morley Cooke said, and she hopes to see it making a positive impact on people’s lives — but affordability of the drug will be important to consider, she added.
Until a review is completed by the Canada Drug Agency, the cost of the new treatment will not be covered by provincial health plans such as OHIP.
No price has been set in Canada yet, but a single year of treatment in the United States costs $26,500. The cost in Canada will likely be similar at the outset, saod Dr. Michael Borrie, the medical director for the Aging Brain and Memory Clinic at St Joseph’s Health Care Parkwood Institute in London.
Lots of interest in London
Patients in London could soon be treated with lecanemab, Borrie said, following a series of tests at his clinic on patients in the early stages of Alzheimer’s.
“Certainly there is a lot of interest in this,” he said. “We’ve been anticipating this for quite some time.”
Lecanemab is only suitable for certain patients, Borrie said.
It is approved for patients in the early stages of the disease who are experiencing memory impairment, he said, and whose capacity for day-to-day living and self-care is either fully intact, or beginning to slip in one or more areas.
Tests are then required to determine whether or not the patient does have a buildup of beta-amyloid in the brain for the drug to target.
Out of around 100 patients at his clinic who are in the early stages of the disease, 70 per cent tested positive for the protein buildup, Borrie said, meaning they could be suitable candidates.
Those candidates would then need to be tested to ensure they do not have two copies of the APOE e4 gene, he added, as studies have shown that these patients are at higher risk of severe side effects, like microbleeds and swelling in the brain.
Health Canada has not approved the use of the drug for those people, who make up about three percent of the general population, but could be as many as half of Alzheimer’s patients at the clinic, Borrie said.
Alzheimer’s research ‘greatly accelerated’
When Morley Cooke’s mother was diagnosed, she ended up in a nursing home, she said. While homes are helpful in providing specialized care, when it came to drug options, nothing was very useful, she added.
The understanding of Alzheimer’s disease has improved greatly, Dr. Michael Borrie said. (Kzenon / Shutterstock)
Borrie is confident, however, that future breakthroughs in Alzheimer’s research are coming, he said.
The last time Health Canada approved a drug for Alzheimer’s was nearly 20 years ago, he added.
In the meantime, the ability to actually measure the underlying disease process using biomarkers — such as the beta-amyloid buildup — has been significant in developing treatments such as lecanemab and will likely lead to even more advances, Borrie said.
“The understanding of the disease has been greatly accelerated,” he said.