New Alzheimer’s wonder drug ‘can slow disease progression by 60pc’

A wonder drug which can slow Alzheimer’s disease by up to 60 per cent is the first step to dementia becoming treatable like diabetes or asthma, experts have predicted.

On Monday, Eli Lilly, the US drugs company, published final results of trials of donanemab, an infusion that helps the brain clear out sticky amyloid plaques that prevent cells from communicating.

As well as postponing a worsening of clinical symptoms, the drug allows patients to continue to perform daily activities for longer, such as shopping, housekeeping, managing their finances and taking medication.

Government advisors said they hoped blood tests to pick up the early signs of Alzheimer’s would soon be available, and included in over-50s screening, so patients would be able to take the drug at the earliest stages of the disease.

“This is truly a turning point in the fight against Alzheimer’s,” said Dr Richard Oakley, associate director of research and innovation at Alzheimer’s Society.

“Treatments like donanemab are the first steps towards a future where Alzheimer’s disease could be considered a long-term condition alongside diabetes or asthma – people may have to live with it, but they could have treatments that allow them to effectively manage their symptoms and continue to live fulfilled lives.”

Mike Colley, 80, from Kent, who took part in the trial, said the drug had allowed him to sing ‘My Way’ in front of 40 guests at his recent birthday party.

“That’s the confidence I have now,” he told the BBC. “I’d never have done that even 12 months ago.”

The breakthrough was hailed as an exciting new era for dementia, but experts warned that currently just two per cent of the 720,000 eligible patients would receive the drug because dementia diagnosis in Britain is so poor.

The NHS has just 88 positron emission tomography (PET) scanners which can detect amyloid plaques in the brain, one of the lowest per capita in the developed world.

The scanners are crucial not only to diagnose the disease, but to check whether the new drugs are working.

Hilary Evans, the chief executive of Alzheimer’s Research UK said: “Probably only two per cent of the people who could benefit from these drugs would necessarily get them because of those hurdles in terms of getting PET scans, we don’t have enough in the UK.

“We don’t want UK patients losing out. Some of this research has worked on in the UK. It would be a real shame if our patients weren’t some of the first to benefit from these treatments.”

Ms Evans, who is also chair of the Government’s mission for dementia, said that the “ultimate end” would be to have patients tested for dementia from their 50-year-old health check onwards.

Blood tests for Alzheimer’s are currently being trialled and could be available by the time the drug passes through regulation.

Eli Lilly said it had already submitted donanemab data to the Food and Drug Administration (FDA) in the US and said submissions to other global regulators are currently underway.

The Medicines and Healthcare Products Regulatory Agency (MHRA) in the UK will then have to determine whether the drug is safe, while the National Institute for Health and Care Excellence has to assess whether they are cost effective for the NHS. The process is likely to take around one year to 18 months.

It is the second Alzheimer’s drug to prove successful in the past year after Eisai/Biogen’s lecanemab was shown to slow decline by 27 per cent, and has now been approved by the FDA in the US.

‘Really encouraging’

Prof Giles Hardingham, interim director of the UK Dementia Research Institute, said: “We have waited a long time for Alzheimer’s treatments, so it’s really encouraging to see tangible progress continuing to gather pace in the field.

“We’re on the edge of exciting and significant change in the landscape of treatment for people affected by or at risk of dementia.”

There are estimated to be 944,000 people living with dementia in Britain, with the majority suffering from Alzheimer’s. The number is expected to increase to more than one million by 2030, with one in three people born in the UK this year expected to develop dementia in their lifetime.

The condition costs the country £34.7 billion annually and is now the leading cause of death, but current drugs can only help symptoms, not put the brakes on progression.

The new drug, which was tested on nearly 1,800 people was found to slow the disease by at least 35 per cent, making it the most efficacious dementia drug to date. For people with the earliest stages of Alzheiemer’s, the drug slowed decline by 60 per cent and for nearly half of trial participants disease progression was halted for at least a year.

But experts said that even if the drugs were approved quickly, the NHS was not ready either to diagnose patients or deliver the medication.

Kate Lee, CEO of the Alzheimer’s Society, said: “New treatments could mean nothing if we don’t fix dementia diagnosis.

“We estimate around 720,000 people in the UK could potentially benefit from these emerging new Alzheimer’s disease treatments if they’re approved for use here. But the NHS is simply not ready to deliver them.

“Alongside this, these emerging Alzheimer’s disease drugs require regular infusions and monitoring, and the NHS is not yet equipped to do this at scale.”

According to Alzheimer’s Research UK, there are currently around 66,000 people waiting for a diagnosis and one in three will never receive one. The wait time for diagnosis is two years on average and more than four years for the under-65s, who are likely to benefit most from the treatment.

Experts said that NHS dementia care needed a significant overhaul before the new treatments could be used.

Dr Liz Coulthard, associate professor in Dementia Neurology, University of Bristol, added: “The resource implications of taking this sophisticated approach are enormous. We need to transform our access to brain scans and infusion suites and train a skilled workforce to deliver these treatments.

“Alzheimer’s is a common condition, and we want people to be eligible for treatment on the basis of need, rather than access being limited to those who can afford private care or live in certain areas of the country.”

The new study was published in the Journal of the American Medical Association (Jama) and presented to the Alzheimer’s Association International Conference (AAIC) in Amsterdam.