“I think this is the first major breakthrough in Alzheimer’s treatment in 30 years,” said Dr. Demetrius Maraganore – chair of the department of neurology at Tulane School of Medicine – of Leqembi, a drug approved by the U.S. Food and Drug Administration last week.
Leqembi works by binding with amyloid-beta soluble protofibrils to reduce amyloid plaques that form in the brain. Maraganore joined WWL’s Newell Normand to discuss this groundbreaking drug.
“These plaques – like in the teeth… [occur] within the space between brain cells and triggers brain cells to become tangled up and then to die,” he explained. “And so many people feel that the key to stopping this cascade of events that leads to cell death and dementia is to reduce amyloid from the brain.”
Patients who took the new drug in trial studies experienced a 30% reduction in disease progression over an 18-month period.
“It basically gives patients a five- or six-month advantage,” said Maraganore. “It’s like it sets the clocks back in terms of their disease progression. And the hope is that those benefits would accrue over a longer length of time.”
Nationwide, more than 6 million people have Alzheimer’s disease, which causes progressive cognitive decline, according to the Alzheimer’s Association, including more than 10% of Americans over age 65. In Louisiana alone, 100,000 patients are dealing with the disease, along with their caregivers and families.
“My father, who has passed, he had Alzheimer’s and I was his caregiver,” Maraganore revealed. “And that was very difficult to watch. He was a brilliant retired physician. And then his mother, my paternal grandmother and her mother, my paternal great grandmother, people who helped raise me as a young child, they had late onset Alzheimer’s as well. So, I really not only have the perspective of the several hundred patients that I care for, but I also have the perspective of being that caregiver and being a son and a grandson… it’s a very moving disease. It’s a devastating disease not only to the patient but to the family.”
While Leqembi is a big step forward, Maraganore noted that it is not a cure. According to the FDA,the medication is for patients with mild cognitive impairment or mild dementia stage of Alzheimer’s disease, and “there are no safety or effectiveness data” on patients with other stages of the disease.
“But, you know, you can’t make a Sazerac without the rye,” said the doctor, referring to the famous New Orleans cocktail. “And never mind that you don't have the absinthe and the simple syrup. So, you know, we’re building a cocktail of drugs, and this is the first main ingredient for that cocktail.”
Going forward, he also hopes to see more “pragmatic” methods of delivery for Leqembi.
“Right now, it’s every two weeks getting an IV infusion,” Maraganore said. “There are efforts underway now to make it self-injectable subcutaneously under the skin every two weeks, which I think would make the treatment much more pragmatic.”
Listen to the doctor’s full conversation with Normand here.
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