Truly support
independent journalism
Our mission is to provide unbiased, fact-based reporting that holds the powerful to account and exposes the truth.
Whether it's $5 or $50, every contribution counts.
Support us in offering journalism without agenda.
The NHS spending watchdog says a drug that has shown signs of slowing the progression of Alzheimer's disease should not be rolled out in the UK's public health service.
According to the National Institute for Health and Care Excellence (NICE), clinical trials have shown lecanemab can slow cognitive decline by four to six months, but the watchdog is concerned about the lack of evidence on its long-term effects and says it cannot justify the cost.
The decision goes against the views of the Medicines and Healthcare products Regulatory Agency (MHRA), which says the drug, developed by pharmaceutical company Eisai and sold under the brand name Leqembi, is safe and effective.
Commenting on the announcement, Hilary Evans-Newton, Chief Executive of Alzheimer's Research UK, said: “Today's news is bittersweet for people affected by Alzheimer's disease.
“It is a remarkable achievement that science is now offering approved treatments that can slow the devastating effects of Alzheimer’s, rather than simply alleviate its symptoms. However, it is clear that our healthcare system is not prepared to accommodate this new wave of Alzheimer’s drugs.” But what is Alzheimer’s and what other treatments are available?
What is Alzheimer's?
“Alzheimer’s disease is a progressive neurodegenerative disorder that primarily affects memory, thinking and behaviour,” explains Dr Ahmad Khundakar, senior lecturer in biomedical sciences at Teesside University. “It is the most common cause of dementia, affecting one in 14 people over the age of 65 and one in six people over the age of 80.”
Khundakar's research primarily involves investigating the molecular and pathological mechanisms underlying neurodegenerative diseases, such as Alzheimer's.
“Pathologically, Alzheimer’s disease is characterized by the buildup of abnormal protein deposits in the brain, known as amyloid plaques and tau protein tangles, which cause brain cells to die,” Khundakar added. “As these proteins spread across different brain regions, they impair function, manifesting in the cognitive and behavioral symptoms characteristic of dementia.”
A common mistake is to believe that Alzheimer's and dementia are the same thing.
“Dementia is actually an umbrella term for a range of disorders that affect cognitive function,” Khundakar explains. “Alzheimer’s disease is just one of those diseases.”
What are the symptoms?
“Early symptoms often involve mild cognitive impairment, such as difficulty remembering recent conversations or events,” Khundakar says.
However, as the disease progresses, affected individuals begin to have difficulty performing everyday tasks.
“Tasks such as managing finances, cooking and caring for oneself become increasingly difficult,” Khundakar explains. “The disease also affects personal relationships, as people may experience depression, agitation or significant personality changes.”
In the later stages, psychological symptoms such as confusion become more pronounced, the professor adds.
Who is most at risk?
Age is widely considered to be the most important risk factor.
“Most cases occur in people aged 65 or older, and the risk nearly doubles every five years after age 65,” Khundakar said.
Your genetics and family history may also play a role.
“Genetics can play a role, especially if there is a family history of Alzheimer’s or if it develops at an early age,” Khundakar explains. “Cardiovascular health is another important factor, as diseases such as diabetes, hypertension and high cholesterol increase the risk.”
How is it diagnosed?
Alzheimer's disease is diagnosed through a combination of clinical evaluations, medical history, and cognitive testing.
“Neuroimaging techniques such as magnetic resonance imaging or PET can reveal brain changes typical of Alzheimer's, such as shrinkage of specific areas such as the hippocampus, which is crucial for memory,” says the professor.
More recently, blood and spinal fluid tests have shown promise in early detection of the disease by identifying biomarkers associated with Alzheimer's, he adds.
What is this new drug lecanemab?
“Lecanemab is one of the first treatments to target the underlying pathology of Alzheimer’s disease, specifically the amyloid plaques in the brain,” Khundakar explains. “It is a monoclonal antibody designed to bind to beta-amyloid plaques, helping to remove them from the brain and slow the progression of cognitive decline.”
However, the professor recognizes his limitations.
“The drug's efficacy was less evident in women and in those with a particular genetic variant known as APOE4,” Khundakar said.
In addition, its production is very expensive.
“The production of monoclonal antibodies is expensive and repeated treatments may be necessary,” he says.
What other treatments are available?
Most treatments available on the NHS focus on symptom control.
“Medications such as acetylcholinesterase inhibitors and memantine may help alleviate cognitive symptoms,” Khundakar says. “Recent advances include the development of disease-modifying drugs that target the underlying pathology of Alzheimer’s disease, specifically amyloid plaques and tau protein tangles in the brain.”
Where can friends and family get support?
There are many charities and helplines in the UK that offer valuable Alzheimer's support and resources.
If your family is looking for advice about a loved one, contact organisations such as the Alzheimer's Society, Alzheimer's Research UK and Age UK Advice Line.
