What Donanemab Means for Alzheimer’s

A new drug to slow down the progression of Alzheimer’s has been hailed a “turning point” in the fight against the disease. Donanemab has been in the news as a revolutionary new treatment that appears to help people with early-stage Alzheimer’s.

Clinical trials suggest the drug can slow down memory loss and a decline in thinking in Alzheimer’s patients. The early success of Donanemab has been hailed a breakthrough by Dr Richard Oakley, the Alzheimer’s Society’s associate director of research.

What is Alzheimer’s disease?

Around 900,000 people in the UK have been diagnosed with dementia – and more than 60% of them are thought to have Alzheimer’s disease, which is the biggest killer disease in Britain.

A brain disorder that destroys memory and thinking skills over time, it eventually causes patients to lose the ability to carry out even the simplest tasks. It is the most common cause of dementia in older adults.

Early-onset Alzheimer’s can occur when a person is between their mid-30s and mid-60s but is very rare. For people with late-onset Alzheimer’s, the symptoms normally begin to show when they are in their mid-60s. This is the most common type of the disease.

Named after Dr Alois Alzheimer, it was first recognised after he studied the brain tissue of a woman who had died of an unusual mental illness in 1906. He found abnormal clumps, later known as amyloid plaques, and tangled bundles of fibres named neurofibrillary tangles.

These are some of the main features of Alzheimer’s, as are changes in the nerve cells in the brain which transmit messages within the brain and to organs and muscles in the body.

Alzheimer’s symptoms

As well as causing people to lose the ability to think and remember things, it gets progressively worse over time, usually over a period of between four and ten years.

People with Alzheimer’s struggle to do everyday tasks such as cooking, driving or paying bills. They often ask the same questions multiple times, get lost when going out, put items in odd places or lose things altogether and find even the simplest things confusing.

Some people become worried, violent or angry as the disease progresses. A symptom known as “sundowning” occurs in late afternoon and through the night, causing greater confusion and leading to sleep issues. They may experience regular difficulties in sleeping – waking up more frequently and staying awake longer during the night.

Special beds for people with Alzheimer’s have been developed to help them have a more comfortable night and deter them from wandering and potentially hurting themselves.

Is there a cure for Alzheimer’s?

Currently, there’s no cure for the disease, although there has been significant progress in developing and testing new Alzheimer’s drugs in recent years. The latest Alzheimer’s drug trials have suggested a breakthrough with Donanemab, which is a disease-modifying treatment.

The first study of the drug took place from May 2013 to August 2016, when 100 people with mild cognitive impairment due to Alzheimer’s took place in the United States.

The most recent trials began in October 2022, when 1,500 participants with the same entry criteria were enrolled to take part. It had a positive effect and the latest results, released in July 2023, showed Donanemab worked better than anticipated.

It is also more effective the earlier it is prescribed during the progression of the disease. Instead of just relieving the symptoms, it tackles one of the root causes of Alzheimer’s.

How does Donanemab help?

New trial results, released in July 2023, showed that it is the most effective Alzheimer’s drug treatment to date, leading to Dr Oakley’s assessment that it was a turning point in managing the disease.

The trials showed how quickly memory and thinking deteriorated by more than 20% for people with Alzheimer’s. When Donanemab was given to the patient early on, it led to the decline in memory and thinking slowing down significantly.

It delayed the progression of Alzheimer’s disease by between 4.5 and 7.5 months over the 18-month trial. After one year of Donanemab, almost 50% of the people taking it had no decline in thinking skills or memory.

The decline in their ability to carry out ordinary day-to-day activities such as driving, enjoying hobbies or managing their finances also reduced by 40% as a result of the drug.

The trial is described as having produced “exciting results”, but more tests are still required, as scientists don’t yet know what it means in the longer term.

There are plans to introduce more diversity into the subjects for further clinical trials to ascertain whether the drug treatment will work for everyone with early-stage Alzheimer’s, no matter what their ethnicity.

Can the NHS prescribe Donanemab yet?

Research and development will continue into Alzheimer’s new drugs, including Donanemab and another potential treatment, Lecanemab (a disease modifying immunotherapy drug) to aid people with early-stage Alzheimer’s disease.

Until the trials and research are complete, the NHS will be unable to roll out the use of Donanemab on a wide scale.

Kate Lee, CEO of the Alzheimer’s Society, said it was a “defining moment” for dementia research, but it could mean nothing if dementia diagnosis wasn’t improved. She explained around 720,000 people in the UK could benefit from the emerging new treatments if they were approved for use.

However, there are fears the NHS isn’t ready to deliver them at present, because it’s struggling to provide a speedy and accurate diagnosis to allow patients to access the medication and treatment they need.

The Alzheimer’s Society says just as there’s been a transformation in cancer treatment in recent times, they’re hopeful they are on the same path for dementia too. Let’s keep our fingers crossed!

For more information on What Donanemab Means for Alzheimer’s talk to Kinderkey Healthcare Ltd