{"id":260178,"date":"2025-11-04T03:17:48","date_gmt":"2025-11-04T03:17:48","guid":{"rendered":"https:\/\/www.newsbeep.com\/ca\/260178\/"},"modified":"2025-11-04T03:17:48","modified_gmt":"2025-11-04T03:17:48","slug":"excitement-around-alzheimers-treatment-tempered-by-questions-about-efficacy-accessibility","status":"publish","type":"post","link":"https:\/\/www.newsbeep.com\/ca\/260178\/","title":{"rendered":"Excitement around Alzheimer\u2019s treatment tempered by questions about efficacy, accessibility"},"content":{"rendered":"

Open this photo in gallery:<\/a><\/p>\n

John Dalrymple-Fraser, a 78-year-old retiree in Peterborough, Ont., is in the early stages of Alzheimer\u2019s disease.Photography by Shay Conroy\/The Globe and Mail<\/p>\n

Lecanemab is the first new treatment for Alzheimer\u2019s disease to reach Canada in 20 years, and Health Canada\u2019s recent authorization of the disease-modifying drug<\/a> has understandably triggered hope and excitement.<\/p>\n

But for some researchers and clinicians who treat the disease, the development also represents a complicated story \u2013 one where enthusiasm for a new and desperately needed drug is tempered by sobering realities around its efficacy, accessibility and impact on an already strained health care system. <\/p>\n

\u201cThis approval is both an incremental improvement and a paradigm shift,\u201d said Andrew Frank, a cognitive neurologist at Bruy\u00e8re Health memory clinic in Ottawa and president of the Consortium of Canadian Centres for Clinical Cognitive Research. \u201cIt\u2019s not a cure. It is an incremental benefit that we hope would lead to more discoveries in the future.\u201d <\/p>\n

In Canada, the Alzheimer Society estimates that more than 770,000 people are living with dementia, an umbrella term for reduced memory and thinking skills \u2013 a number that\u2019s expected to rise to nearly one million by 2030.<\/p>\n

More about lecanemab: Alzheimer\u2019s trial brings at-risk patients hope for the future, but new doubts in the present<\/a><\/p>\n

The Decibel: How a new kind of drug could change the future of Alzheimer\u2019s<\/a><\/p>\n

Alzheimer\u2019s disease is the most common cause of dementia, and drug companies have poured billions into searching for a \u201cdisease-modifying therapy\u201d \u2013 a drug that tackles the root causes of the disease, rather than just treating its symptoms. After decades of failures, the arrival of monoclonal antibodies such as lecanemab, sold under the brand name Leqembi, was greeted excitedly by the global dementia community. Some even speculated they could be the \u201cbeginning of the end\u201d for Alzheimer\u2019s disease.<\/p>\n

But real-world and clinical trial data have since painted a more muted picture. The drug only slows the progression of disease by a modest amount for patients with mild cognitive impairment or early Alzheimer\u2019s; clinical trial data show that participants who took the drug over 18 months saw their disease progression delayed by about five months compared with those in the control group.<\/p>\n

\u201cWe need to be very clear with the public health system that the clinical effect is very, very modest,\u201d said Manuel Montero-Odasso, a geriatrician and clinician-scientist with Western University who recently served as president of the Canadian Geriatrics Society.<\/p>\n

He said he is also \u201cvery worried\u201d about eligibility for the drug. In the United States, where lecanemab has now been available for two years, only between 8 per cent and 15 per cent of people who\u2019ve wanted the drug have been eligible to receive it, he said.<\/p>\n

Open this photo in gallery:<\/a><\/p>\n

Mr. Dalrymple-Fraser holds a photo of himself and his mother on his wedding day. Both of his parents suffered from the disease.<\/p>\n

The drug, administered through intravenous infusions every two weeks, also requires a dramatic rethinking of Canada\u2019s current dementia-care landscape. In 2021, a paper published by the journal Alzheimer\u2019s & Dementia warned that Canada would have the longest wait times for disease-modifying drugs such as lecanemab among G7 countries, because of its \u201climited capacity for memory care.\u201d<\/p>\n

In order to qualify for lecanemab in Canada, patients must first undergo genetic testing to determine whether they\u2019re at heightened risk of developing serious side effects, as well as tests to detect the presence of beta-amyloid plaques \u2013 the sticky protein that builds up in the brain, triggering a cascade of events that lead to brain-cell death. <\/p>\n

There are currently only two tests for detecting amyloid, neither of which are routinely performed when diagnosing Alzheimer\u2019s in Canada: a lumbar puncture or spinal tap, and an amyloid PET scan. According to Dr. Frank, public coverage for either procedure is extremely limited.<\/p>\n

Explainer: What is Alzheimer\u2019s disease?<\/a><\/p>\n

Opinion: Canada has a chance to change the Alzheimer\u2019s experience \u2013 let\u2019s not squander it<\/a><\/p>\n

All of this, combined with lecanemab\u2019s price tag \u2013 currently unknown in Canada, but set at US$26,500 annually in the U.S. \u2013 translates to significant barriers to access. A major outstanding question is whether the drug will be publicly covered; in Britain, the body that advises the National Health Service recommended against publicly covering lecanemab, arguing the benefits were too small to justify the cost.<\/p>\n

Patients on lecanemab will also require at least five MRIs within six months of starting the therapy in order to get a baseline picture and monitor for side effects, which can include brain microbleeds and swelling. The Canadian Association of Radiologists recently warned of a deepening crisis in wait times<\/a> for medical imaging such as MRIs.<\/p>\n

Dr. Montero-Odasso worries that lecanemab\u2019s introduction could divert significant resources away from other supports or interventions that could meaningfully affect Alzheimer\u2019s patients and their families. <\/p>\n

But he also sees the profound impact that such drugs can have, even with all their flaws and challenges.<\/p>\n

Open this photo in gallery:<\/a><\/p>\n

Mr. Dalrymple-Fraser enrolled in one of the clinical trials studying lecanemab two years ago. He still doesn\u2019t know if he\u2019s receiving the actual drug or the placebo, but he has no doubt about the potential value that such a drug could have.<\/p>\n

John Dalrymple-Fraser, a 78-year-old retiree in Peterborough, Ont., has seen the devastating effects of Alzheimer\u2019s firsthand. Both of his parents suffered from the disease, as did two of his first cousins.<\/p>\n

He is now in the early stages of Alzheimer\u2019s himself. Two years ago, he enrolled in one of the clinical trials studying lecanemab. While he still doesn\u2019t know if he\u2019s receiving the actual drug or the placebo, he has no doubt about the potential value that such a drug could have, even if it only gives him a few more good months.<\/p>\n

\u201cIt could make all the difference in the world,\u201d Mr. Dalrymple-Fraser said. \u201cIf tomorrow, I couldn\u2019t remember my family [but] I\u2019m told that taking this drug [means] I could for at least five more months? Give me that drug.\u201d<\/p>\n","protected":false},"excerpt":{"rendered":"Open this photo in gallery: John Dalrymple-Fraser, a 78-year-old retiree in Peterborough, Ont., is in the early stages…\n","protected":false},"author":2,"featured_media":260179,"comment_status":"","ping_status":"","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[34],"tags":[901,888,902,879,877,903,49,48,876,895,896,891,878,875,46,549,295,894,887,914,880,881,893,84,392,889,890,884,904,885,909,910,912,907,911,905,908,882,898,899,714,897,906,865,61,900,892,886,883,913],"class_list":["post-260178","post","type-post","status-publish","format-standard","has-post-thumbnail","category-healthcare","tag-alberta","tag-arts-news","tag-bc","tag-breaking-news","tag-breaking-news-video","tag-british-columbia","tag-ca","tag-canada","tag-canada-news","tag-canada-sports","tag-canada-sports-news","tag-canada-trafficcanada-weather","tag-canadian-breaking-news","tag-canadian-news","tag-economy","tag-education","tag-environment","tag-federal-government","tag-foreign-news","tag-globe-and-mail","tag-globe-and-mail-breaking-news","tag-globe-and-mail-canada-news","tag-government","tag-health","tag-healthcare","tag-life-news","tag-lifestyle","tag-local-news","tag-manitoba","tag-national-news","tag-new-brunswick","tag-newfoundland-and-labrador","tag-northwest-territories","tag-nova-scotia","tag-nunavut","tag-ontario","tag-pei","tag-photos","tag-political-news","tag-political-opinion","tag-politics","tag-politics-news","tag-quebec","tag-sports-news","tag-technology","tag-travel","tag-trudeau","tag-us-news","tag-world-news","tag-yukon"],"_links":{"self":[{"href":"https:\/\/www.newsbeep.com\/ca\/wp-json\/wp\/v2\/posts\/260178","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/www.newsbeep.com\/ca\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/www.newsbeep.com\/ca\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/www.newsbeep.com\/ca\/wp-json\/wp\/v2\/users\/2"}],"replies":[{"embeddable":true,"href":"https:\/\/www.newsbeep.com\/ca\/wp-json\/wp\/v2\/comments?post=260178"}],"version-history":[{"count":0,"href":"https:\/\/www.newsbeep.com\/ca\/wp-json\/wp\/v2\/posts\/260178\/revisions"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/www.newsbeep.com\/ca\/wp-json\/wp\/v2\/media\/260179"}],"wp:attachment":[{"href":"https:\/\/www.newsbeep.com\/ca\/wp-json\/wp\/v2\/media?parent=260178"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/www.newsbeep.com\/ca\/wp-json\/wp\/v2\/categories?post=260178"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/www.newsbeep.com\/ca\/wp-json\/wp\/v2\/tags?post=260178"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}