What New Drugs Can Slow the Progression of Alzheimer’s Disease?

Alzheimer’s disease impacts millions worldwide, bringing significant challenges to patients, families, and healthcare providers. Despite being incurable, ongoing research and advancements in treatment offer hope for slowing the disease's progression. Recently, several new drugs targeting Alzheimer’s at its root biological processes have emerged, particularly for patients in the early stages. This article delves into these promising therapies, their mechanisms, and their role in Alzheimer’s management.

Key Points

New Alzheimer’s treatments focus on slowing disease progression rather than curing it.
FDA-approved drugs like donanemab and lecanemab show promising results in early-stage Alzheimer’s patients.
Additional therapies, including tau-targeting drugs and gene-based treatments, are under investigation.

How Do New Alzheimer’s Drugs Work?

Recent advances in Alzheimer’s research focus on targeting the biological mechanisms that drive the disease, particularly amyloid plaques and tau tangles:

Amyloid-targeting drugs: These medications focus on removing or reducing amyloid beta plaques, protein clumps that disrupt communication between neurons. By breaking down these plaques, drugs like donanemab and lecanemab help preserve brain function.
Tau-targeting therapies: Tau proteins form tangles that spread in the brain during Alzheimer’s progression. Emerging therapies aim to halt or slow this process, particularly in advanced stages.

By addressing these key pathological features, new treatments aim to delay the onset of severe symptoms.

What Are the Latest FDA-Approved Treatments?

Donanemab (Kisunla)
- Approved by the FDA in 2023, donanemab targets amyloid plaques to slow cognitive decline.
- Clinical trials showed significant benefits for patients with early-stage Alzheimer’s, especially those with low-to-moderate tau levels.
- Side Effects: Patients may experience ARIA (Amyloid-Related Imaging Abnormalities), including brain swelling or microhemorrhages.
Lecanemab (Leqembi)
- Approved in 2022, lecanemab works by binding to soluble amyloid beta, preventing its accumulation into plaques.
- Studies demonstrated a 27% slower decline in cognitive abilities over 18 months in patients with mild cognitive impairment (MCI) or early Alzheimer’s.
- Monitoring: Routine MRI scans are recommended during treatment to manage potential risks.

What Are the Benefits and Risks of These Drugs?

Benefits:
- Slower cognitive decline, allowing patients to maintain independence longer.
- Improved quality of life for both patients and caregivers.
Risks:
- ARIA-related side effects like brain swelling or bleeding occur in up to 40% of patients.
- Headaches, dizziness, and confusion may also arise during treatment.
- Regular monitoring and close medical supervision are essential for safe use.

Are There Any Drugs Currently in Clinical Trials?

Several promising drugs are in various stages of development:

Remternetug: This next-generation amyloid-targeting drug shows promise in Phase III trials, with enhanced efficacy and safety profiles compared to earlier treatments.
Tau-targeting therapies: These drugs, still in early trials, aim to prevent tau tangles from forming or spreading in the brain.
Gene-based therapies: Focused on modifying genetic risks, such as the APOE4 gene, gene-editing techniques offer a potential long-term solution to Alzheimer’s susceptibility.

How Do These Medications Fit Into a Comprehensive Care Plan?

While these drugs mark significant progress, they work best as part of a holistic approach to Alzheimer’s care, which includes:

Cognitive training: Programs designed to maintain memory and problem-solving skills.
Lifestyle interventions: Healthy diets, regular exercise, and stress management improve overall brain health.
Support networks: Involving caregivers, healthcare professionals, and Alzheimer’s organizations ensures patients receive comprehensive care and resources.