A new drug against Alzheimer’s disease was approved on January 6 by the American health authorities (Food and Drug Administration, FDA), lecanemab, marketed by the Eisai and Biogen laboratories, under the name of Leqembi. This monoclonal antibody, which aims to reduce cognitive decline, is intended for patients with a mild form of this neurodegenerative disease. It affects approximately 55 million people worldwide. No treatment to curb it exists to date. There have been many disappointments over the past twenty years, the latest concerning Aduhelm (aducanumab), also developed by Eisai and Biogen.
Although the causes of Alzheimer’s disease remain poorly understood, it is characterized on the pathophysiological level by changes in the brain. Beta-amyloid plaques, formed by the abnormal accumulation of a protein called beta-amyloid, are deposited between nerve cells located in the gray matter of the cerebral cortex, causing dysfunction of the connections between neurons. There is also neurofibrillary degeneration, an abnormal accumulation of filaments inside neurons, linked to the deleterious effect of the tau protein. “These two lesions correspond to clusters of proteins that form during the normal aging process. However, in Alzheimer’s-like diseases, these proteins accumulate in much greater quantities.”precise the Alzheimer Research Foundation website.
However, lecanemab targets the so-called beta-amyloid protein. Published in the New England Journal of Medicine November 29the results of the study conducted on 1,795 participants (898 of whom received the molecule) showed that lecanemab, administered by intravenous infusion every two weeks, reduced amyloid markers by more than 50%. They also demonstrated a 27% reduction in cognitive disorders after eighteen months of treatment compared to the placebo.
The researchers used the Clinical Dementia Rating Scale to assess cognitive (memory, orientation, judgment) and social (acts of daily living, occupations, etc.) functions. Questions are asked of patients and their relatives, and a severity score is assigned to each factor. In the end, the total scores range from 0 to 18, with the score from 0 to 6 indicating an early stage of the disease. The mean baseline score for both groups was 3.2. At the end of the eighteen months, it was 1.21 for those who had taken lecanemab, against 1.66 for the placebo group, a difference of 27%.
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