Lecanemab, a drug trialed at the Hunter Medical Research Institute (HMRI) in Australia, is showing promise in slowing cognitive decline in individuals with early Alzheimer's disease. The drug, currently under review for approval by the Therapeutic Goods Administration (TGA), has demonstrated the ability to remove amyloid plaques from the brain, potentially altering the course of the disease.
Understanding Lecanemab's Mechanism
Beta amyloid is a naturally occurring protein in the brain that, when uncleared, can accumulate and form plaques. These plaques inhibit neuronal function, leading to cognitive decline and, ultimately, Alzheimer's disease and dementia. Lecanemab works by targeting and removing these amyloid deposits.
Professor Michael Breakspear, a psychiatrist and neuroscientist from HMRI's Brain Neuromodulation Research Program, emphasized the significance of Lecanemab's ability to clear amyloid from the brain. Preliminary findings suggest that this action can prevent Alzheimer's disease and dementia from developing in healthy individuals and may slow cognitive decline in those already experiencing symptoms.
Clinical Trial Details and Results
The clinical trial involved a rigorous screening process for volunteers aged 65-80. Participants underwent online surveys, saliva tests for genetic risk profiling, MRI scans, and PET scans to determine amyloid accumulation in the brain. Those identified as high risk were then administered either Lecanemab or a placebo via bi-weekly infusions over two years. A total of 400 people participated in the trial nationwide, with 200 screened in the Hunter region, 60 scanned, and 20 found to have amyloid, of whom five participated in the clinical trial.
Lecanemab has demonstrated a 25% slowing of mental decline in people with mild dementia. This outcome positions it as the first drug proven effective in modifying the course of Alzheimer's disease.
Context of Dementia in Australia
Dementia poses a significant health challenge in Australia, with over 400,000 Australians currently living with the condition and approximately 150,000 new cases diagnosed annually. Without medical breakthroughs, Dementia Australia projects that the number of people with dementia will double by 2058.
Regulatory Status and Future Availability
While already approved and available in the United States, Lecanemab is currently under review by the TGA for approval in Australia. Approval is anticipated by the end of 2024, potentially offering a new treatment option for Australians at risk of or in the early stages of Alzheimer's disease.
