In Beating the Dementia Monster, we told the story of my rejection from the clinical trial for aducanumab. After the trials had their rather ragged ending, Biogen marketed the monoclonal antibody as Aduhelm. Several members of the FDA's advisory panel quit in disgust with the FDA's decision to approve it, and Biogen marketed it initially at $52K/year. Then Medicare placed some significant restrictions on when it would be covered. So it had a rocky start.
Enter lecanemab. Marketed as Leqembi, this was Biogen's commercial version of the newer monoclonal antibody that had looked better in clinical trials than aducanumab. So, in January of this year, Biogen discontinued sales of Aduhelm in favor of Leqembi.
In Beating the Dementia Monster, we referred to lecanemab by its original code name, BAN2401.
If a drug's generic name has "mab" at the end, it's a monoclonal antibody. For a refresher, some antibodies are taken from the blood of elderly people who do not have Alzheimer's disease. The antibodies identify and destroy beta amyloid in the brain. These are peptides that appear in Alzheimer's disease and seem to be one cause of memory loss. So these mabs are good at cleaning out the brain. The ability to clean amyloids out of the brain is an amazing feat of science, but that this will improve memory and cognition is based on the "amyloid hypothesis." And that is very much in question. As we discussed before, cleaning out the amyloid plaques doesn't always lead to improved memory and cognition.
I wanted to mention here that, by all indicators, I continue to do quite well. I continue to apply all of the Dementia Toolkit, and my subjective experience with respect to memory and cognition seems to me to be consistent with the complaints of my friends of the same age.
Researchers at the University of Washington continue to test me weekly, and I am quite happy with my unscientific analysis of my results. However, they are only testing my short term memory, which I believe only informs us about what is happening in my hippocampus. But that's ground zero for Alzheimer's disease, and it tells me a lot.
What's frustrating is the continuing deterioration of my balance. I'm told this is neurodegenerative cerebellar dysfunction ataxia. Nevertheless, when I wake up each morning, I can't believe how great I feel and how positive things really are. (I just think back to how things were in 2015, before I began implementing the Dementia Toolkit.)
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