In June I posted that the US Food and Drug Administration (FDA) had controversially approved aducanumab under an ‘accelerated approval process’ for the treatment of Alzheimer’s disease. That post goes into some detail – if interested, you may like to read it. Essentially I understand that this drug has been shown to reduce amyloid deposition in the brain and probably to slow or stop cognitive deterioration but not improve cognitive function.
Neurologist Jason Karlawisch, speaking about advice he would give to a patient with Alzheimer’s, wrote: “I will instruct patients and their caregivers to weigh the drug’s uncertain benefit against the burdens of intravenous infusions every 4 weeks, frequent imaging studies, a copay [copayment] that might be in the thousands of dollars, and risks of brain edema and microhemorrhages. About one-third of patients taking aducanumab experience these risks. And because these risks are more common in persons with the APOE4 gene compared with those without the gene (42% vs 20%, respectively), whether to undergo genetic testing is another choice patients will need to make.”
The American Academy of Neurology recently issued a position statement** for neurologists setting out issues for neurologists, patients and their families related to aducanumab and Alzheimer’s disease.
I received an invitation by the ‘Biogen ANZ Medical Team’ to an “interactive discussion on the timely diagnosis of Alzheimer’s disease” and I attended this yesterday. Biogen is the research company behind aducanumab. The seminar mounted by ‘ADvance – Biogen Alzheimer’s Education’ was of a high standard, did not promote Aduhelm but did strongly support early detection, diagnosis using Amyloid Beta SPECT imaging and ‘biomarkers’ in blood and cerebrospinal fluid. Such an approach to definitive early diagnosis is necessary if Aduhelm is to be given. A/Prof Michael Woodward, who chaired and presented, provided information about non-drug interventions which might follow on from early diagnosis, including exercise, diet, attention to blood pressure management, and management of other cardiovascular risk factors.
*Aducanumab and the Business of Alzheimer Disease-Some Choice. Jason Karlawish. JAMA Neurol. 2021;78(11):1303-1304
** https://www.aan.com/PressRoom/Home/PressRelease/4937