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Tuesday, July 25, 2023

The Fight Against Alzheimer ’s Disease

New FDA-approved treatment provides hope for patients with early-stage Alzheimer’s disease

It is estimated that 6.7 million people aged 65 and older are living with Alzheimer’s disease in the United States, according to the Alzheimer’s Association, and an estimated 7,000 to 8,000 people in the Shreveport-Bossier City area suffer from this disease. It is the most common cause of dementia and the seventh leading cause of death in the U.S. for adults.

Alzheimer’s is a progressive disease, meaning it gets worse over time.

Current treatments may temporarily improve symptoms of Alzheimer’s disease but don’t change the disease process to prevent or slow progression. However, a new treatment recently approved by the U.S. Food and Drug Administration (FDA) is providing scientists, doctors and people with early-stage Alzheimer’s disease with some much-needed good news.

The FDA granted traditional approval to Leqembi on July 6. This is the first treatment for Alzheimer’s disease to be approved that targets amyloid plaques in the brain, a key characteristic of Alzheimer’s disease. Leqembi was granted accelerated approval in January 2023 after Phase 3 randomized, controlled clinical trial results confirmed that the drug had clinical benefits. Following a confirmatory trial that verified these clinical benefits, Leqembi was granted full, traditional approval and is now available as a treatment for patients with early-stage Alzheimer’s disease and covered by Medicare. Leqembi was reported to slow the progression of Alzheimer’s disease by up to 27%, which is a clinically meaningful slowing of cognitive and functional decline. Leqembi is the first approved drug to this magnitude of an effective response.

The article which reported the benefit of Leqembi was published in the New England Journal of Medicine on Jan. 5, 2023. It was an 18-month study on people with early Alzheimer’s disease. Leqembi is an anti-amyloid antibody that was found to promote removal of beta-amyloid plaques in the brain.

A previous drug, aducanumab, had previously been reported to be of some benefit, but the results of the aducanumab study were somewhat conflicting. The FDA expert panel ultimately did not favor approval, and the drug is now back in clinical trial. In a previous trial over 10 years ago, we participated in a trial for a drug called bapineuzumab. This drug was similar to Leqembi, but this agent was not found to be effective in protecting against progression of Alzheimer’s disease.

There are certain guidelines to identify patients who are eligible to receive Leqembi. Patients must be in the early stage of the disease. Because Alzheimer’s is a progressive disease, damage that has already been caused by protein buildup that leads to amyloid plaque forming in the brain cannot be reversed. Leqembi protects against the progression of the disease and helps a person affected by Alzheimer’s maintain their quality of life for longer by specifically targeting beta-amyloid plaques. Patients must also have amyloid buildup for the drug to be effective. Determining if beta-amyloid plaque is the cause of cognitive decline can be done with a positron emission tomography (PET) scan or through spinal fluid evaluation. Screening is important in determining if a treatment will be safe and effective for the patient. Leqembi is administered as an infusion every two weeks, and patients are closely monitored for their response to the treatment and any side effects.

While there is still work to be done and researchers around the world continue to work tirelessly to learn more about degenerative brain diseases, what causes them and possible therapeutics and preventions, this newest treatment approved by the FDA is an exciting and important step in the fight against Alzheimer’s disease. For more information and to determine if you are eligible to receive Leqembi, call the Ochsner LSU Health Shreveport Neurology Clinic at (318) 626-0526.

Navigating Alzheimer’s disease and treatment options can be overwhelming, so it is vital to have resources available to people affected by the disease and their loved ones. The LSU Health Shreveport Center for Brain Health has several studies relating to brain health that are open to participants who meet study requirements, which you can learn more about by calling (318) 813-

3610. The Bridge Alzheimer’s & Dementia Resource Center is an excellent local organization that offers education and support services, including a new online support group available for caregivers that will be held via Zoom every third Wednesday of the month at 1 p.m. If you are interested in attending an online support group meeting, you can register by calling The Bridge at (318)- 656-4800.

The Center for Brain Health and The Bridge Alzheimer’s & Dementia Resource Center offices are located at 851 Olive St. For more information on resources, treatment options, local clinical trials opportunities, or general questions about Alzheimer’s disease and dementia, call 318-656-4800 or visit www.lsuhs.edu/cbh or www. alzbridge.org.

Elizabeth Disbrow, Ph.D., is a professor of neurology and director of the Center for Brain Health at LSU Health Shreveport. Roger Kelley, MD, is a professor of neurology at LSU Health Shreveport.

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