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Medicine Science

Alzheimer's Drug Donanemab Helps Most When Taken at Earliest Disease Stage, Study Finds 34

Posted by msmash from the encouraging-feedback dept.
An experimental drug can slow progression of Alzheimer's disease in those who start taking it when the disease is still in its early stages. Nature: The drug, a monoclonal antibody called donanemab, does not improve symptoms. But among people who started taking it at the earliest stages of Alzheimer's, 47% had no disease progression on some measures after one year, compared with 29% who took a placebo. The drug does not provide as much benefit to people at later stages or those with a common genetic variation that raises the risk of the disease.

The results are "very encouraging," says neurologist Reisa Sperling at Harvard Medical School in Boston, Massachusetts, particularly because they are similar to those of a similar drug called lecanemab. "It makes me feel we are on the right track." Donanemab's manufacturer Eli Lilly, based in Indianapolis, Indiana, presented the results of the 1,736-person trial today at the Alzheimer's Association International Conference (AAIC) in Amsterdam, and published them1 in JAMA. The company released partial results in May, but researchers still had questions about the drug's safety and efficacy in certain groups.
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Alzheimer's Drug Donanemab Helps Most When Taken at Earliest Disease Stage, Study Finds More

Alzheimer's Drug Donanemab Helps Most When Taken at Earliest Disease Stage, Study Finds

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  • Now the question is... (Score:4, Interesting)

    by TWX ( 665546 ) on Tuesday July 18, 2023 @04:05PM (#63697250)

    ...how to know when to get tested. What sort of criteria apply? Family history? Forgetfulness? What are the long term prognoses of those who take this? Will it hold back the waters for a very long period of time, or will the patient just begin the descent a short time later and still reach the same sort of point as if they hadn't taken it?

    • Get tested when you forget that you need to get tested.

    • Re:Now the question is... (Score:5, Informative)

      by omnichad ( 1198475 ) on Tuesday July 18, 2023 @04:33PM (#63697324) Homepage

      There is promising research on early detection through a simple blood test:
      https://science.slashdot.org/s... [slashdot.org]

      It's possible that this gets cheap enough to do broad screening after a particular age.

      • There is promising research on early detection through a simple blood test: https://science.slashdot.org/s... [slashdot.org]

        It's possible that this gets cheap enough to do broad screening after a particular age.

        It'll be great when they extend dementia from 10 years until death to maybe 20.

        Of course that means you spend more years in that last part, wearing depends, only knowing who you are for a few minutes a week, and depleting your estate for more years. And it does the family's hearts good to see you that way for a longer period. 8^/

        Did you know that some people in nursing homes die while they still have money? How the hell can the nursing home deal with that business model heartbreak? So this can be a win

        • Im fairly sure that if I get diagnosed, my first point of call is to the gun shop to make a hole in my skull the plaques can't fill.

          Or I dunno, try heroin or something. Go out with a smile on my dial.

          Whatever the case, I aint going out a frightened demented wreck. Seen that, not fun. The usual way you die of dementia is choking to death when your nervous system finally forgets how to cough.

          What a horror, no.I aint going out like that if I have any say in the matter.

          • Im fairly sure that if I get diagnosed, my first point of call is to the gun shop to make a hole in my skull the plaques can't fill.

            Or I dunno, try heroin or something. Go out with a smile on my dial.

            Whatever the case, I aint going out a frightened demented wreck. Seen that, not fun. The usual way you die of dementia is choking to death when your nervous system finally forgets how to cough.

            What a horror, no.I aint going out like that if I have any say in the matter.

            Agree 100 percent. Once upon a time a person with dementia didn't last too long, maybe a couple of years. Then with the help of 24/7/365 care and early drugs, it was extended to around 10 years. Now? Who knows? It doesn't change a damn thing, only makes each stage all that much longer. But anyone who has watched a family member on that "long goodbye" as they call it will tell you it is a long torture. Coupled with the systematic acquiring of every cent they have managed to save, it is cruelty writ large.

        • Re: (Score:1)

          by BranMan ( 29917 )

          Hate to break it to you, but the deal you get with a nursing home includes them getting the rest of your money if you die before you spend it all on care.

          • Hate to break it to you, but the deal you get with a nursing home includes them getting the rest of your money if you die before you spend it all on care.

            People seem to love to hate breaking things to me. 8^) All of my parents and in-laws died over a 5 year period, and 3 went to nursing homes, 2 died at home. (not a typo) an account was opened of estate contents, access to to the nursing homes and with myself or my SO having power of attorney, each and every month a deduction was made, and we got notices of that deduction.

            After passing, we received the rest of the estate.

            If the Estate was depleted before the person passed, the nursing home would start

    • Given the description of "needs to be taken early on, slows things for about a year", this also applies to existing medication for Alzheimers, e.g. cholinesterase inhibitors to boost acetylcholine levels. This one isn't a cholinesterase inhibitor but it also doesn't mention whether it's better than existing stuff which is available as generics so (outside the US) of marginal cost to sufferers.

      And answering my own question, donanemab is projected to be available for USD 28,000 year, compared to say donepez

  • Now this is a story.. (Score:4, Funny)

    by Junta ( 36770 ) on Tuesday July 18, 2023 @04:22PM (#63697288)

    That would be understandable to see duped a few times...

  • Let me see, a treatment works better when the damage is the least? Which is in the earliest stages, gosh n golly.

    • Well with Alzheimer's anything is a win. If i recall correctly, that is. What was I saying?

    • Some treatments work by preventing damage. Others work on cleaning up amyloid plaques - which doesn't reverse the disease but works well even in late stages at slowing progression.

      • Some treatments work by preventing damage. Others work on cleaning up amyloid plaques - which doesn't reverse the disease but works well even in late stages at slowing progression.

        Miss me with that stuff. My MIL was on that sort of thing. Just extended the part where she had no idea who she was, and it was a lot of fun watching her body disintegrate the last couple years - well, no it wasn't.

        If I reach that state, I'm hoping I have a gun cleaning accident.

    • "47% had no disease progression on some measures after one year, compared with 29% who took a placebo."

      29% is not bad. Would be nice if they put the placebo on the market as well.

      • The following paper found average placebo effectiveness to be in general 34% https://www.ncbi.nlm.nih.gov/p... [nih.gov]

      • So the improvement was only 47 - 29 then? That is only 18% who had improvement attributed to the drug, right? And that is IF you can get it and IF you can afford it and IF you are in the right stages of the disease.... and hopefully with no long-term gotchas or side-effects.

        Somehow this doesn't sound at all as exciting as all the stories make it out to be.

        • Somehow this doesn't sound at all as exciting as all the stories make it out to be.

          Exactly. If a medication isn't 100% effective it's not worth it and should be abandoned.

          • I would say a medication that is not significantly better vs the placebo should be avoided.

          • >"Exactly. If a medication isn't 100% effective it's not worth it and should be abandoned."

            I am not saying that at all. But an 18% chance that it might SLOW, not cure the disease, doesn't sound like a breakthrough or all that exciting. But there are articles everywhere making it sound like it is some kind of miracle. Of course it is better than nothing, if you are eligible AND get it AND can afford it.

            By the way, the same excitement revolved around things like Donepezil. And now it seems it does very

      • Would be nice if they put the placebo on the market as well.

        Tapwater is free. So is Prayer.

        Neither actually do anything, but thats kind of the point of a placebo.

    • Re:Tell me any treatment that is less effective la (Score:4, Informative)

      by quantaman ( 517394 ) on Tuesday July 18, 2023 @05:34PM (#63697430)

      Let me see, a treatment works better when the damage is the least? Which is in the earliest stages, gosh n golly.

      It's not nearly as obvious as you think it is.

      FTA:

      Tau levels increase as Alzheimer’s progresses, although its role in the disease is still poorly understood.

      People with low or moderate levels of tau who took donanemab declined 35% more slowly over 76 weeks than those who took a placebo. But those with high tau levels declined at the same rate regardless of whether they took donanemab or a placebo.

      The null hypothesis would be that if the drug reduced progression it would do so at all stages of the disease.

      But in this case it reduces the progression of the disease, but only if they take it in the early stages.

      • There's many possible explanations for why it only works in the early stages. Here's one: In the early stage, the amount of AB (specifically, a pyroglutamate-modified Abeta) that has to be cleared is less, whereas in an advanced stage those AB peptides exist in numerous cells and have already caused the permanent damage to the neurons. The drug wastes itself by binding the AB in cells that are already broken/damaged so the probability of the drug reaching and clearing the AB in healthy cell that hasn't yet

  • https://redlightsonthebrain.bl... [redlightsonthebrain.blog]

    Red lights on the brain apparently help (the link above describes a DIY device).

    Amyloid plaques buildup within the brain is associated with Alzheimer's. This buildup is apparently triggered by failures in overnight cleanup processes during sleep. That is when the cerebrospinal fluid floods the brain's intracellular spaces and removes waste material built up over the day.

    Red light and near infrared light stimulate mitochondria in cells to provide more energy for cellular proc

  • They would have you take the drug from birth until the day you die.

  • One might almost say an ounce of donanemab, taken early on, is worth a pound of it taken later on, to coin a phrase.

  • Buying our product for as much of your life as possible helps most

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