Breakthrough Alzheimer’s drugs rejected for use on the NHS. Here’s how they work

Two drugs to treat Alzheimer’s disease were rejected for use on the NHS Because their advantages are “too small” to justify their cost, said the healthcare dog.

Donanemab and LecaneMab are targeted antibodies drugs that slow down the early stages of Alzheimer by targeting a known cause, rather than simply treating symptoms.

The two drugs bind to the amyloid, a protein that accumulates in the brain of people living with Alzheimer’s disease, and are designed to help erase construction and slow down cognitive decline.

However, during the publication of his final project, the National Institute for Excellence of Health and Care (Nice) said that the treatments have proven to delay the progression of the light to moderate Alzheimer from four to six months, which he described as only “modest advantages at best”.

What are the drugs?

Donanemab and LecaneMab are targeted antibodies drugs that slow down the early stages of Alzheimer’s.

They represent a huge step forward in research because they target a known cause of the disease, rather than simply treating symptoms.

The two drugs bind to the amyloid, a protein that accumulates in the brain of people living with Alzheimer’s disease.

By binding to the amyloid, drugs are designed to help cleanse accumulation and slow down cognitive decline.

To what extent are they effective?

Donanemab has been demonstrated in clinical trials to slow down the speed at which memory and thought worsened by more than 20%.

The evidence suggests that people get the most advantages if they receive treatment earlier in the disease.

The results also suggest that the drug leads to a 40% slowdown in the decline of daily activities such as driving, the profit of hobbies and the management of money.

Ilanemab has also been successfully eliminated the accumulation of brain proteins from people living with early Alzheimer’s disease.

For people who take Lecanemab, this meant that the drop in their thoughts of thought and memory was slowed by 27%.

He also slowed down the drop in quality of life to 56%.

How are drugs given?

Donanemab, developed by the Pharmaceutical Company Lilly, is given to patients via an intravenous drop once every four weeks.

Lecanemab, developed by Eisai, is also given in this way, but bimonthly.

Are there side effects?

The side effects of drugs can be serious and people are monitored to check them.

In a clinical trial published in the Journal of the American Medical Association (JAMA) in 2023, 24% of people receiving Donanemab had side effects, including swelling of the brain and reactions related to the infusion.

Four people died during the trial, with their death which was linked to the side effects of the drug.

LecaneMab has led to reactions related to infusion in approximately 26% of people on the trial and followed, while 14% underwent imagery anomalies linked to the amyloid, causing swelling of the brain. Others have undergone minor bleeding, picked up scans.

About one in 10 people suffered headaches, according to the results updated in May 2024.

Overall, four deaths during the follow -up period would be due to treatment.

How much are the drugs?

The NHS England published a briefing document last year suggesting that the cost of setting up medicines to health service could be 500 million pounds sterling at 1 billion pounds sterling per year.

About 50% to 60% of the total estimated cost relates to the price of the drug, with the rest of the money spent on the evaluation, diagnosis and administration of patient treatment.

How many people in England would the drugs have worked?

The NHS in England estimated that between 50,000 and 280,000 patients could be eligible for new treatments if they were approved for the NHS.

To obtain the drugs, patients need a basic MRI, then a TEP-CT scan or lumbar perforation to confirm Alzheimer’s disease.

It is possible that blood tests are available in the future to diagnose the disease, so that the NHS in England warned that there should be the prudence of the conduct of a “massive expansion” in other diagnoses, which could become redundant in the longer term.

What do scientists think?

Scientists and doctors have been divided on the question of whether drugs represent a real clinical advantage which is perceptible in day -to -day patients.

Some maintain that drugs represent a huge advance, and people should have the opportunity to try them.

But others say that the advantages are too small.

Jennifer Keen, associate director of evidence, politicians and influence at Alzheimer’s Society, said that “we remain at an important and exciting moment”.

“There are currently 182 active clinical trials for Alzheimer’s disease … We are at the dawn of large scientific breakthroughs that are starting to improve perspectives for people with the disease.”

Professor Rob Howard, London University Collegesaid that “no one should be surprised that Nice has confirmed their previous opinion that new treatments for Alzheimer’s disease would not be profitable if they were used in the NHS.

“Well comforted clinical trials have shown that the actual size of the benefits suffered by patients was too small to be noticeable, the treatment involves side effects and the annual cost of the required medication and safety surveillance would have been close to the cost of the wages of a nurse for each treated patient.

“We need better treatments that can make an appreciable difference in the lives of people with dementia And these can only come from research and additional studies. »»