Test effective treatments as potential preventions

Contributed by Joshua Grill, PhD

Since the announcement by Eisai and Biogen on Wednesday of the first positive Phase 3 results for their lecanemab treatment in early-onset Alzheimer’s disease, the field was clearly aligned. Most agree we need to see the data, but this seems like a clear win and a big step in a positive direction.

Some debate has begun, and more will occur, about the size and significance of victory, i.e. the size of the drug’s disease-slowing effects and clinical significance. These debates will be extremely important but will take time.

Joshua Grill, PhD

Combined with recently published data for another monoclonal antibody, Eli Lilly’s donanemab, the results seem important for another reason. It is increasingly clear that for these treatments to work best, they must be started early in the disease. Fortunately, the estate is committed to promising monoclonal antibody prevention trials that are currently recruiting people without any memory problemsincluding the AHEAD study which features Eisai’s lecanemab and enrolls in UCI MIND.

Trials such as the AHEAD study are testing an important hypothesis: reducing amyloid levels in the brain before symptoms even begin may delay or even prevent their onset. Starting treatments as soon as possible aims to slow the disease when the damage is minimal and at a time when even small effects could produce large long-term benefits.

Another landmark study of an anti-amyloid antibody as a potential preventative, the A4 study, is expected to wrap up in the coming months and announce results early next year. The A4 study is testing solanezumab, an antibody that works differently from lecanemab. The A4 study had many volunteers dedicated to the UCI MINDnow for many years, who are committed to helping answer these important questions.

It’s an exciting time, hopefully the dawn of an era where we can transform the way we treat, diagnose, and even think about Alzheimer’s disease. However, much remains to be done. UCI MIND faculty and staff stand ready to make a meaningful contribution to this work and to share these exciting results with the public.

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