By WKTV Staff
Few diagnoses are more frightening than hearing that one has Alzheimer’s or another disease that causes dementia.
The Alzheimer’s Association estimates about one in nine Americans over 65 have Alzheimer’s disease. This number is expected to more than double in 25 years.
“Alzheimer’s is a complicated disease,” said Kevin Foley, MD, FACP, AGSF, Medical Director of the Trinity Health Medical Group Alzheimer’s Disease and Memory Disorders Program at Trinity Health Hauenstein Neurosciences – Grand Rapids Campus. “Even though it was discovered more than 100 years ago, we have yet to really understand what causes it, whether genes, environmental triggers, or something else.
“The formation of amyloid plaques in the brain is a hallmark of the disease, and the process can begin up to 10 years before a person shows any symptoms.”
While advances in treating cancer, diabetes, heart disease, and other neurodegenerative diseases like Parkinson’s, have been made in recent years, nothing seemed to have worked as well for treating Alzheimer’s.
Hope for slowing cognitive decline
In 2021, the Food and Drug Administration (FDA) approved aducanumab, an amyloid-beta-attacking monoclonal antibody—a lab-made version of an antibody found in the human immune system.
Aducanumab was the first drug ever approved for slowing cognitive decline in Alzheimer’s patients. But trial data showed – at best – hints of a possible, small average slowing in cognitive decline.
In 2023, the FDA approved lecanemab (Leqembi®) using the Accelerated Approval Pathway (AAP). Under the AAP, the FDA may approve drugs for serious conditions where there is an unmet medical need and a drug is shown to have an effect on a surrogate endpoint that is reasonably likely to predict a clinical benefit to patients. In this case, the surrogate endpoint is removal of amyloid.
“Lecanemab can slow the progression of mild cognitive impairment and mild dementia due to Alzheimer’s disease by eliminating amyloid protein from the brain,” said Dr. Foley. “It is classified as a ‘disease modifying’ drug, and the evidence so far shows a modest effect on slowing memory decline by several months.”
This treatment may be effective for patients in the early stage of the disease when symptoms, such as difficulty remembering names and completing tasks, are still manageable without much daily support.
Procedure and cost details
Dr. Foley and his team have two patients currently undergoing lecanemab infusions. More patients are going through the screening and approval process to see if they are a candidate for the treatment.
If a patient is approved, lecanemab is given as IV infusion every two weeks for 18 months. Brain MRIs will be done along the way to monitor for side effects. Patients also must be re-certified at six months to continue the treatment.
Health insurance plans will cover some of the expenses associated with the screening and treatment. There is no cost for the recertification at six months. An annual estimate for all non-covered expenses associated with screening and treatment is $6,000 – $7,000. The actual amounts covered are insurance company specific, so actual out of pocket costs could be less than this estimate.
Hope for the future
“For patients with Alzheimer’s, the hope of staying at the same level longer and slowing how fast it progresses, so they can keep doing what they enjoy, is important,” said Dr. Foley. “While this is not a ‘cure’ for disease, further studies may lead to an even more successful treatment.”
