By Vimal Aga MD (bio) and Rajnish Mago MD (bio)
This article was first published on September 12, 2023. It was last reviewed, updated, or edited on February 4, 2024.
In 2021 and 2023, the United States Food and Drug Administration (FDA) announced the approval of two treatments for Alzheimer’s disease that are qualitatively different from those that have been available so far because they are “disease-modifying treatments”:
– Aducanumab (brand name Aduhelm®). But, on January 31, 2024, the manufacturer announced the discontinuation of the development and marketing of aducanumab.
– Lecanemab (brand name Leqembi®)
What are “disease-modifying treatments” for Alzheimer’s disease?
These two medications have significant limitations and problems, which we will discuss elsewhere on this website. But, irrespective of the controversies, the FDA approvals of aducanumab and lecanemab were important steps forward for so-called “disease-modifying treatments” for Alzheimer’s disease dementia.
Treatments for dementia are of two fundamentally different types (Cummings et al., 2022):
1. Disease-modifying treatments — Treatments that aim to affect the underlying disease processes
2. Symptomatic treatments — Treatments that improve the symptoms of dementia (cognition, neuropsychiatric symptoms) without addressing the underlying pathology.
Symptomatic treatments do have value, of course, but we desperately need disease-modifying treatments for Alzheimer’s disease that could modify or slow down the disease process. Of the nearly 150 drugs in development as possible treatments for Alzheimer’s disease, about 80% are potentially disease-modifying treatments (Cummings et al., 2022).
Next, please see the following articles on this website about the role of amyloid beta in Alzheimer’s disease and about anti-amyloid beta antibodies as “disease-modifying” treatments for Alzheimer’s disease:
Why amyloid-β and amyloid plaques are so important
Untangling exactly whom lecanemab is FDA-approved for
How well does lecanemab medication work?
Lecanemab carries an important boxed warning
Should we recommend treatment with lecanemab?
Related Pages
Neurocognitive disorders in DSM-5
“Mixed pathologies” in Alzheimer’s disease
Sundowning in patients with dementia is important!
Does new-onset psychosis late in life predict the onset of dementia?
In older adults, avoid medications with anticholinergic activity
Neuroimaging in persons with dementia
New, “disease-modifying” treatments for Alzheimer’s disease
Why amyloid-β and amyloid plaques are so important
Untangling exactly whom lecanemab is FDA-approved for
How well does lecanemab medication work?
Lecanemab carries an important boxed warning
Should we recommend treatment with lecanemab?
Practice guidelines for dementias
References
Prescribing Information for lecanemab (Leqembi®)
Prescribing Information for aducanumab (Aduhelm®)
Cummings J, Lee G, Nahed P, Kambar MEZN, Zhong K, Fonseca J, Taghva K. Alzheimer’s disease drug development pipeline: 2022. Alzheimers Dement (N Y). 2022 May 4;8(1):e12295. doi: 10.1002/trc2.12295. PMID: 35516416; PMCID: PMC9066743.
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