Swissmedic is poised to decide by the end of the year on the approval of lecanemab, potentially marking the first new drug for Alzheimer's disease in Switzerland in two decades. The decision comes amid divided opinions on the drug's efficacy and safety.
Lecanemab, marketed as Leqembi, received FDA approval in July 2023 for treating early Alzheimer's disease and has since been approved in Japan, China, and South Korea. It is designed to address both the symptoms of memory loss and the underlying cause of the disease by targeting amyloid plaques in the brain.
Diverging Opinions on Lecanemab's Efficacy
Andrea Pfeifer, CEO of AC Immune, noted that the approval of lecanemab in the US was a significant step forward, as it reignited hope in Alzheimer's research. However, the European Medicines Agency (EMA) recommended rejecting the drug in July 2024, citing concerns over safety, including brain swelling and bleeding. Similarly, while the UK regulatory agency authorized lecanemab, the National Institute for Health and Care Excellence (NICE) did not recommend it for reimbursement due to its high cost relative to its benefits.
Clinical Trial Results and Expert Interpretations
Clinical trial data involving over 1,700 participants with early Alzheimer's showed that lecanemab slowed cognitive decline by 27% compared to a placebo over 18 months. Despite this, some experts suggest that the observable benefits for patients might be marginal, potentially delaying dementia by only a few months. Jacqueline Wettstein, a spokesperson for Alzheimer Suisse, emphasized that while lecanemab can delay disease progression if administered early, it is not a cure.
Weighing Benefits Against Risks
The benefits of lecanemab must be weighed against its side effects, which include brain swelling and microbleeds. Antonella Santuccione Chadha of the Women’s Brain Foundation suggests that the risks may be justified to advance research in a field where numerous clinical trials have failed. IQVIA estimates the cost to develop an Alzheimer’s drug at approximately $5.6 billion, underscoring the financial challenges in this area.
The Future of Alzheimer's Research
Currently, there is no approved blood test to detect the progression of Alzheimer's, and existing drugs primarily ease symptoms rather than reverse the disease. Pfeifer highlights the need for early intervention, potentially 15 to 20 years before symptoms manifest. AC Immune is developing diagnostic tests and immunotherapies aimed at clearing plaques from the brain, with five drugs currently in clinical trials.
Swissmedic's decision on lecanemab will not only affect patients in Switzerland but also influence future investments in Alzheimer's research. The agency's assessment will focus on the drug's efficacy, quality, and safety, with a decision expected by the end of 2024.
