By allowing a new anti-Alzheimer’s disease drug this week, US authorities have given an encouraging signal to relaunch research that has slowed in the last 20 years.
The US Food and Drug Administration (FDA) approved, on Monday, a treatment against Alzheimer’s disease called “Adohelm” developed by the American company “Biogene” for the pharmaceutical industry.
And this step took place for the first time since 2003. Even before that, the treatments allowed for use were limited to treating the symptoms of Alzheimer’s, not the cause of the disease.
As for the “Biogen” treatment, it works to damage the plates formed by proteins in the patients’ brain called “amyloid”.
These proteins constitute a major cause of Alzheimer’s disease by compressing nerve cells, leading to a gradual loss of memory and even the ability to distinguish.
Hilary Evans, director of the British Alzheimer’s Research Foundation, considered this development a “pivotal moment in research to develop revolutionary new treatments against Alzheimer’s disease”.
The American admission of this treatment was the first significant progress for patients and their families after nearly two decades without any new developments or treatments.
But Stéphane Aibelbaum, a neurologist and researcher at the Pettier Salpetriere Hospital in Paris, told the French news agency, “This period allowed us to achieve tremendous progress in understanding the disease, the way it appears, its cause and diagnosis,” especially at an early stage.
“But it is difficult for us to turn all these advances into clinical successes,” he added.
At this time, the disease continues to spread, especially due to the high rates of aging of the population around the world. The World Health Organization estimates that there are at least thirty million cases of Alzheimer’s disease in the world, despite the difficulty of distinguishing between this disease and other forms of dementia.
And Eppelbaum expressed “the fear of being overly hopeful about the effectiveness of the treatment.”
This expensive drug, with an annual cost of more than $50,000, is only intended for a small group of patients in the very early stages of the disease. Even for these, the treatment has only been shown to be of limited efficacy.
This makes sense, as Alzheimer’s disease generally does not progress quickly and during the 18 months in which the Biogen treatment was tested, cognitive tests showed little difference between patients who received it and those who received a placebo.
The pharmaceutical group also caused confusion by announcing in 2019 the failure of one of its experiments before retracting these statements.
An expert panel (FDA) also recommended not authorizing the treatment, but the US agency did not act on this recommendation. It is also not certain that the European Union and Britain, where Biogen has also requested a license, will give their consent for the treatment.
Should the United States have waited? Not necessarily because her decision would allow evaluation of the treatment’s effectiveness in the real world, by measuring its ability to reduce dementia over ten or fifteen years.
Neurologist Jonathan Scott of University College London concluded via Twitter on Wednesday that “any drug, no matter how good, will not alone provide a solution for Alzheimer’s patients,” stressing the need to prevent dementia.