Antibody Treatments Slow Disease Progression
The Food and Drug Administration approved Eli Lilly’s Kisunla for mild and early cases of Alzheimer’s disease. It’s only the second drug that’s been shown to delay cognitive decline in patients, following last year’s approval of a similar drug from Japanese drugmaker Eisai.
These new drugs can slow down the disease, but not cure them. The delay in mental decline seen with both drugs is about seven months. Patients and their families must weigh that benefit against the downsides, including regular infusions and side effects such as brain swelling.
Both Kisunla and the Japanese drug, Leqembi, are antibodies that target amyloid plaque buildup in the brain, which contributes to the death of neurons and the propagation of a deadly protein that infects the entire body.
Costs vary based on treatment duration. A year’s worth of therapy will cost $32,000 (versus $26,500 for LEQEMBI®). Each vial of Kisunla costs $695.
Patients with early or mild neurodegenerative disease will be eligible for the new drug.
Each candidate must meet clinical criteria to get a prescription. Doctors can stop the treatment after brain scans confirm the removal of most plaque buildup.
The FDA approved Kisunla (donanemab) based on an 18-month study. Patients given the treatment declined about 22 percent more slowly in terms of memory and cognitive ability than those who received a placebo.
Kisunla is injected once a month compared to Leqembi’s twice-a-month regimen. First, doctors must confirm that a patient with dementia has the brain plaque targeted by the new drugs. Then they must find a drug infusion center where a patient can receive therapy. Meanwhile, nurses and other staff must be trained to perform repeated scans to check for brain swelling or bleeding. In clinical trials, patients were taken off Kisunla if their brain plaque became nearly undetectable. Almost half of patients reached that point within one year.
The FDA approved the first anti-amyloid beta treatment in the United States one year ago. LEQEMBI® is an intravenous infusion given every two weeks to treat Alzheimer’s disease. Eisai and Biogen will continue to accelerate development of potential new treatments.
The new treatments for Alzheimer’s disease are not cures. They slow down disease progression, but they do not stop mental decline.
The FDA and the pharmaceutical companies haven’t indicated whether the new treatments have been tested on other forms of neurodegenerative disease, including Parkinson’s disease.
Meanwhile, nutritional therapy also offers hope to those trying to avert and treat all forms of neurodegenerative disease. Extra virgin olive oil, walnuts, pomegranate, salmon, apples, bananas, oranges and much more contain compounds that can penetrate the blood-brain barrier. They also can help purge deadly proteins from the brain. They can help prevent the build-up of plaque in the first place. A healthy heart also helps keep plaque out of the brain, so get plenty of exercise.
“Many factors contribute to the causes of neurodegenerative disease,” said Gary Chandler, a healthcare author and advocate. “Prevention is the best hope against Alzheimer’s disease, Parkinson’s disease and other forms of prion disease.”
The food and water that we consume can help prevent and treat neurodegenerative disease. High cholesterol increases the risk by more than 70 percent, while diabetes and high blood pressure carry a 30-40 percent greater risk. Individuals who are overweight before age 65 face a 40 percent greater risk for developing neurodegenerative disease.
The medical term for ALS, Alzheimer’s disease, Parkinson’s disease, Creutzfeldt-Jakob disease, mad cow disease, chronic wasting disease and related diseases is transmissible spongiform encephalopathy (prion disease). The operative word is “transmissible.”
Despite the smoke and mirrors, the major difference between all of these forms of neurodegenerative disease is the species under attack by infectious prions. The primary difference between Alzheimer’s disease and Parkinson’s disease, for example, is the region of the brain that is under attack by the pathological protein.
