The Guardian view on Alzheimer’s drugs: a working therapy would be a breakthrough | Editorial

The search for a cure for dementia continues, but scientific advance in treatment is a landmark moment

Finding a cure for Alzheimer’s disease, the most common form of dementia, is the holy grail of medical research. The incurable malady is – along with other dementias – the leading cause of death in the UK. Until now, no therapy had emerged that could even slow its lethal brain shrinkage, let alone stop or reverse its grim progression. Treating dementia has also been an underfunded cause. By some estimates, more research has been done on Covid in the past three years than on dementia in the past century. Yet this week, a drug that works for Alzheimer’s has appeared on the horizon, raising hopes that there may be some relief from a deadly and cruel condition.

The drug, lecanemab, is a landmark in medicine, and the first treatment to slow cognitive decline in Alzheimer’s patients. People understandably focus on breakthroughs that deliver a cure. Dementia is a frightening disease. It may begin innocuously enough, with a little forgetfulness. But the sickness gnaws away at a person’s mental agility, their memory and ultimately their personality. Patients can end up delusional, incontinent and incapable of looking after themselves. Death arrives on average about eight years after the initial diagnosis. Lecanemab’s effect is modest. In a clinical trial involving 1,800 patients in the early stages of Alzheimer’s, the drug slowed its development over 18 months by about a quarter.

Some scientists say that while the results are statistically significant, individual patients might not perceive much – if any – difference. Others have questioned whether the drug’s side-effects outweigh its benefits. The drug, significantly, points to a possible cause of the illness. The theory is that a protein, beta amyloid, and another it encourages, called tau, harm brain neurons to such an extent that they die off. Because lecanemab is an antibody therapy that removes beta amyloid, it provides a much-needed fillip for the hypothesis that the protein might be a key that could unlock Alzheimer’s secrets.

This is no academic discussion. Between 2007 and 2019, more than a dozen final-stage trials of amyloid-targeting drugs reported results. None slowed cognitive decline; some even made it worse. When, last year, a therapy that targeted beta amyloid became the first new Alzheimer’s drug in two decades to receive US approval, because it might help moderate symptoms, the decision became a flashpoint in a vexed scientific debate.

US regulators are expected to approve lecanemab for use in January. Britons will have to wait longer. First, UK medical watchdogs would have to judge the drug’s safety, and then if its cost could be justified. If the benefits of lecanemab could be sustained, experts suggest, a patient might have seven and a half years of independent living – rather than the current six – before they need support at home. The arrival of dementia treatments will need more NHS resources. Hospitals would require accurate diagnostic tests to swiftly identify patients likely to benefit, specialist staff to provide regular drug infusions, and MRI scans to keep tabs on patient progress.

Dementia becomes more common in old age. As life expectancy rises, the number of people suffering with the illness will surge. This week’s scientific advance is good news. Yet patients will still need to be cared for, often for many years. Dementia is perhaps the greatest medical and ethical challenge of the age. One can only hope that the British state, after a decade of ministers failing to fix the broken social care sector, is up to the test.



The GuardianTramp

Related Content

Article image
We’ve got the first Alzheimer’s drug in decades. But is it a breakthrough?
Aducanumab’s approval masks the fact that we’re still very far from sure what causes the most common form of dementia, says Kansas State University professor Han Yu

Han Yu

28, Jun, 2021 @9:00 AM

Article image
Are we really on the brink of a cure for Alzheimer’s? | Dean Burnett
The headlines claim treatment is almost here. But the reality is more complex, writes neuroscientist Dean Burnett

Dean Burnett

25, Sep, 2018 @4:11 PM

Article image
The Guardian view on new drugs: high hopes, higher prices | Editorial
Editorial: The row over the cost of a cystic fibrosis treatment has prevented its use in the UK. These patients, many of them children, deserve better


03, Feb, 2019 @6:45 PM

Article image
The Guardian view on antidepressant use: no cure-all | Editorial
Editorial: The record number of pills being handed out for depression is a cause of concern, especially when access to other treatments is restricted


31, Mar, 2019 @5:24 PM

Article image
The Guardian view on autism awareness: recognising diverse talents – and needs | Editorial
Editorial: Growing diagnosis of the condition needs to be matched by increasing acceptance and support


01, Apr, 2021 @5:53 PM

Article image
The Guardian view on tax and the NHS: honesty is overdue | Editorial
Editorial: Politicians of all stripes have for too long avoided confronting hard truths about rising demand for health services and how to meet the cost


23, May, 2018 @11:01 PM

Anti-allergy drug may tackle symptoms of Alzheimer's

Drug previously used as antihistamine in Russia may help sufferers of Alzheimer's disease, says Lancet

Sarah Boseley, health editor

17, Jul, 2008 @11:01 PM

Article image
It’s just a first step, but this new Alzheimer’s drug could be a huge breakthrough | Jonathan Schott
Recent lecanemab trials are reason for hope, although health services may struggle to deliver treatments, says dementia researcher Jonathan Schott

Jonathan Schott

30, Nov, 2022 @9:48 AM

Article image
Alzheimer’s drugs are a ray of hope. They must be accessible to all, not the wealthy few | Devi Sridhar
There are now two impressive possible treatments for this form of dementia. But concerns remain over cost and potential side-effects, says Devi Sridhar, chair of global public health at the University of Edinburgh

Devi Sridhar

18, May, 2023 @2:46 PM

Article image
The Guardian view on opioids in the the UK: poverty and pain | Editorial
Editorial: These painkillers don’t work against chronic pain. The UK must find alternatives to help sufferers in deprived areas


28, Feb, 2019 @6:33 PM