Headline: Alzheimer's drug lecanemab hailed as momentous breakthrough

[Darat]

https://www.bbc.co.uk/news/health-63749586

What a nice piece of positive news -

Quote:

One of the world's leading researchers behind the whole idea of targeting amyloid 30 years ago, Prof John Hardy, said it was "historic" and was optimistic "we're seeing the beginning of Alzheimer's therapies". Prof Tara Spires-Jones, from the University of Edinburgh, said the results were "a big deal because we've had a 100% failure rate for a long time".

...snip....

Lecanemab is an antibody - like those the body makes to attack viruses or bacteria - that has been engineered to tell the immune system to clear amyloid from the brain.

Amyloid is a protein that clumps together in the spaces between neurons in the brain and forms distinctive plaques that are one of the hallmarks of Alzheimer's.

...snip...

I'm sure most of us older folk will know of family or friends that have been struck down by Alzheimer's. Hopefully this will only be the start of effective treatments.

[Jack by the hedge]

It's very welcome news. Even if the effect of this treatment is only a modest slowing of the rate of progress, it's a remarkable achievement and as you say I hope it's only the start.

[Mike!]

My wife's grandfather had Alzheimer's and it was heartbreaking. I never knew him beforehand, only the shell of a man he became. He would sit in the corner of her mothers living room asking, "Why are you people keeping me here against my will? Why are you doing this to me?" If he got out on his own he'd walk a few blocks to the house he'd lived in half a century earlier. "My key doesn't work and they said I don't live here."
Another friends father had it and one day he wandered off and has never been seen again.
So here's hoping this turns out to be a major breakthrough treatment.

[erlando]

Alzheimer's runs in my mother's family. I have one of the two genes that purportedly are "trigger genes" for Alzheimer's. That's why one of my greatest fears is to get afflicted with Alzheimer's.

I am hopeful that this breakthrough is the start of effective treatments of Alzheimer's.

[casebro]

The old man/ friend a couple doors down has just had his drivers license pulled....

His son got him an Apple watch w/ GPS. He does wear it every day, so far.

I wonder if they can engineer something to dissolve the calcium deposits I have in my arteries, veins, valves, joints....

[Chris_Halkides]

In September medicinal chemist Derek Lowe wrote, "At the same time, though, news like this needs to be examined carefully. As the world knows, the anti-amyloid clinical landscape for Alzheimer's is absolutely littered with failures in every direction: anti-amyloid antibodies of various types, attempts to inhibit beta-secretase and gamma-secretase enzymes, attempts to prevent aggregation, you name it. Nothing has worked. The presumption at this point is that such therapies will not succeed, so if lecanemab has indeed worked, the question is what makes it different. There's a ready answer (up to a point) because antibodies can indeed be quite different (that's their point!) and if you do manage to hit exactly what needs to be hit, you could expect efficacy when apparently similar attempts have led to nothing."

Dr. Lowe indicated that he would return to this topic when more data were made available, which was originally thought to be in November.

[casebro]

Some recent reading indicated that the amyloid theory was wrong. The the original researcher fibbed about his findings to improve awareness or some such. So amyloid treatments may not be the silver bullet for Alzheimer's.

[bobdroege7]

Originally Posted by casebro

Some recent reading indicated that the amyloid theory was wrong. The the original researcher fibbed about his findings to improve awareness or some such. So amyloid treatments may not be the silver bullet for Alzheimer's.

We don't talk about that on our conference calls.

Redundant analytical equipment for testing Flutemetamol, or known by its commercial name Vizamyl, is my gig. A drug used for PET scans to monitor the plaques.

Things are quiet, a dose here, a dose there, supposed to pick up soon.

[casebro]

Originally Posted by bobdroege7

We don't talk about that on our conference calls.

Redundant analytical equipment for testing Flutemetamol, or known by its commercial name Vizamyl, is my gig. A drug used for PET scans to monitor the plaques.

Things are quiet, a dose here, a dose there, supposed to pick up soon.

[QUOTE} https://en.wikipedia.org/wiki/Flutemetamol_(18F) "Of the 176 patients imaged in this trial had a median age was 82, with 57 of patients being female. The initial flutemetamol PET scan resulted in 43 positive and 25 negative results for cerebral cortisol amyloid status." [/quote]

Looks to me that in 60% of patients results were inconclusive. Is that good enough for a test? We talk of false positive and false negative rates, but 60% inconclusive? Hmmm, that study was done in people with cognitive impairment. umm, if 60% had inconclusive amyloid levels, is amyloid the problem?

[Planigale]

If you keep on testing drugs I guess by chance one will have a positive result! The disease progressed in both treatment and placebo arms. The difference in progression seemed greater in the placebo than the treatment arm. The difference was small, statistically significant, but I am not sure if it would be clinically significant. The treatment was expensive the infrastrucure to use it is significant.The side effects are significant.

I don't think this particular drug is a great breakthrough. My guess is it will be slow to be licensed in Europe.

[lomiller]

The second line in the article

Quote:

Yet the medicine, lecanemab, has only a small effect and its impact on people's daily lives is debated.

This wouldn't be the first treatment that reduced Amyloid but had little impact on cognitive degeneration. While undoubtedly connected to the disease it doesn't look like clearing Amyloid will ever be an effective treatment.