A recent revolutionary change in the guidelines for diagnosing Alzheimer’s disease and the new drugs for its treatment are shifting outcomes for patients in the early stages of the disease. Professor David Tanne, director of the Stroke and Cognition Institute at Rambam Health Care Campus (Rambam) in Haifa, Israel, and outgoing chairperson of the Israel Neurological Association and Professor Judith Aharon-Peretz, director of Rambam’s Cognitive Neurology Unit, explain the profound implications of the new guidelines and new drugs.
(L) Professor David Tanne; (R) Professor Judith Aharon-Peretz. Photography: Rambam HCC.
New criteria published by Alzheimer’s Disease International, dedicated to the treatment, support, and research of the disease, mark a significant shift from a solely clinical diagnosis to one based on biological markers, akin to diagnosing diseases such as cancer, heart disease, and diabetes.
Previously, diagnosing Alzheimer’s disease (AD) relied heavily on cognitive decline and impaired daily functioning. However, the updated guidelines allow diagnosis using biological markers and blood tests, enabling disease detection before symptoms manifest.
Professor Judith Aharon-Peretz elaborates, “The revised criteria define AD as a biological process that begins with the appearance of changes in the brain. These changes occur before memory and thinking problems emerge.”
In parallel to the new criteria, earlier this year, the FDA approved two new drugs for the treatment of early-stage Alzheimer’s: lecanemab (Leqembi™) and donanemab-azbt (Kisunla™). Both drugs are proving to be effective in delaying the progression of AD.
Rambam’s Stroke and Cognition Institute is one of only two medical centers in Israel treating Alzheimer patients with lecanemab, and only a few other medical centers in the USA and Japan use it. Clinical trials show lecanemab’s efficacy in delaying cognitive and functional decline during treatment. Rambam’s first patient, a woman in her 50s diagnosed with early-stage AD, is the first patient at Rambam to be treated with this “wonder drug,” which is administered intravenously every two weeks.
“Early diagnosis and use of advanced drugs are slowing the progression of AD in its early stages,” explains Professor Tanne. “We are in the midst of an exciting, dynamic, and changing period in the diagnosis and treatment of the disease—I would define this as the beginning of a diagnostic and therapeutic revolution.” Explaining that the drug is suitable for men and women with biologically confirmed early-stage AD, he adds, “There are additional criteria for selecting patients for treatment and Rambam’s Stroke and Cognition Institute has established a system to treat early-stage Alzheimer patients with advanced drugs.”
There are about 150,000 AD and dementia patients in Israel. However, neither lecanemab nor donanemab-azbtare are available in Israel’s basket of national health services. Professor Tanne points out that the growing market for these new drug therapies can accelerate the process leading to their inclusion, thereby making treatment accessible to more patients throughout Israel in the near future.
“As more drugs for treating Alzheimer’s disease are approved, patients will have more treatment options,” concludes Tanne, “and Rambam will be there for them.”
Comments