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UH begins offering new treatment for Alzheimer’s disease


UH begins offering new treatment for Alzheimer’s disease

CLEVELAND, Ohio — University Hospitals Brain Health & Memory Center has announced that it will begin treating Alzheimer’s disease patients with the drug lecanemab, the first FDA-approved treatment that addresses the underlying biology of Alzheimer’s for people in the early stages of the disease.

Lecanemab was granted accelerated FDA approval in January 2023, and traditional FDA approval in July. Treatments are given by IV infusion every two weeks, throughout the course of a year, with each session lasting about one hour. Infusions occur for one year for a total of 26 treatments.

Lecanemab is a drug made from an antibody. It specifically targets the amyloid-beta protein that accumulates in the brains of people with Alzheimer’s disease and forms the characteristic plaques that are associated with cognitive decline.

It is thought that by binding to the amyloid proteins, the drug assists a person’s immune system to remove the plaques from the brain.

Medical research

“We’re happy to be able to offer this breakthrough treatment to our patients at UH,” said Dr. Charles J. Duffy, neurologist and Director of the Brain Health & Memory Center within the UH Neurological Institute. “This new drug has shown significant promise in clinical trials and may be a treatment option for patients with mild cognitive impairment and mild dementia due to Alzheimer’s disease.”

Studies with lecanemab consistently show marked reduction in the amount of amyloid accumulation in the brain. While it does not cure the disease, it does appear to slow its progression. In the clinical trial that led to FDA approval, cognitive decline in patients taking lecanemab over the course of 18 months was slowed by 27% compared to patients taking a placebo.

Under the conditional accelerated approval, the Centers for Medicare and Medicaid Services, which operates Medicare, decided it would not cover the $26,500 yearly cost of lecanemab unless people were part of a clinical trial that continues to gather safety and effectiveness data on the medication.

However, once the drug received full approval in July, CMS has said it would cover the cost of the drug as long as patients are enrolled in a registry that requires doctors to continue to report safety and effectiveness data for their patients using it. Individual insurance coverage may vary, and the hospital is advising patients to talk to their provider to determine coverage before beginning treatment.

According to the CDC, Alzheimer’s disease affects about 5.7 million Americans, including 1 in 10 adults aged 65 and older. It is the sixth leading cause of death among all adults and the fifth leading cause for those aged 65 or older. In 2020, the estimated cost of caring for and treating people with Alzheimer’s disease was $305 billion. By 2050, these costs are projected to be more than $1.1 trillion.

Despite the drug’s hefty price tag, proponents of its use argue that it has the potential to create huge cost savings for health care. In a paper published by the University of Chicago, researchers have estimated that the health system could save anywhere from $300 billion to $1.8 trillion overall if more people with Alzheimer’s were treated with drugs like lecanemab that can delay progression of their disease.

Lifestyle changes can also have a significant impact on slowing the progression of the disease. A report by the Lancet claims that by addressing 12 different lifestyle factors— things like smoking, obesity and exercise— cognitive decline can be delayed or reduced by up to 40%. That’s more than the 27% recorded with lecanemab.

“While there currently is no cure for Alzheimer’s, lecanemab may slow progression of the disease, enhance patients’ ability to participate in daily life, and allow them to live independently for a longer period of time,” Duffy said.

Those with symptoms of early Alzheimer’s disease and the confirmed presence of beta-amyloid plaques in the brain may be eligible for treatment. Early symptoms of Alzheimer’s may include: mild cognitive impairment, such as forgetfulness and confusion, and mild dementia, such as difficulty performing familiar tasks. The therapy has not been tested on people with advanced Alzheimer’s or those without clinical symptoms.

Although there is no single diagnostic test to confirm Alzheimer’s disease, physicians may use a variety of approaches to help them make a diagnosis and determine if treatment with lecanemab might be appropriate.

Tests and procedures may include: Comprehensive personal and family medical history; Mental status tests; Physical and neurological exams; Blood tests; Spinal tap to remove a sample of cerebrospinal fluid for testing; MRI of the brain; and PET scan of the brain to look for the presence of beta-amyloid plaques.

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