Alzheimer’s Drug Fails: Latest Research & What It Means

The National Institute of Excellence in Health and Social Services recommended on Thursday not to reimburse Leqembi. This Alzheimer’s drug, approved this fall by Health Canada, contains « uncertainties in terms of effectiveness and side effects,” concludes INESSS.

The Quebec Federation of Alzheimer Societies decried the decision, calling it “a setback for people living with the disease and their loved ones.” ».

Lecanemab is a “monoclonal antibody” that attacks amyloid plaques, deposits in the brain that are associated with Alzheimer’s disease. Its trade name is Leqembi and it should cost between $32,000 per year according to its manufacturer, Eisai.

This is an infusion treatment, which can be given in specialist infusion clinics. In the United States a home injectable version has been approved for follow-up treatments (18 months after treatment initiation).

Lecanemab can only treat mild cases of Alzheimer’s and patients with two copies of a gene linked to Alzheimer’s, APOE4, do not have access to it according to Health Canada’s decision. It is not approved for other types of dementia, for which amyloid plaques generally do not play a role.

INESSS concludes that lecanémab has no “clinically significant” results or “demonstrated improvement in quality of life”.

Christian Bocti, neurologist at Sherbrooke University Hospital, believes that INESSS’s decision is the right one. He points out that few public plans in the world reimburse lecanémab. According to Eisai, the public Medicare plan in the United States as well as those in Germany and Japan reimburses the drug. French, English and Australian public plans, among others, do not reimburse lecanémab, which is approved in more than 50 countries.

“But INESSS has not said that they do not want to pay for it because it is too expensive,” observes Simon Ducharme, neuropsychiatrist at the McGill University Health Center. “They concluded radically that in their opinion the drug does not work, contrary to Health Canada and the English and European organizations. »

Elsewhere in the country, reimbursement of the drug by public plans will depend on the opinion of the Canadian Medicines Agency, which the D^r Ducharme is due in a few months.

Robert Laforce, neurologist at the University Hospital of Quebec, who published an open letter in support of lecanémab in October, condemned the INESSS decision. “By ignoring very convincing data, INESSS deprives patients in the early stages of Alzheimer’s disease of a treatment that could slow progression and preserve their autonomy at a time when it is still possible to intervene. »

According to the D^r Laforce, approximately 5% to 10% of patients in cognitive impairment clinics in the United States may benefit from lecanemab.

Currently, only one other class of dementia drugs exists, which increases the amount of acetylcholine in the brain. This molecule helps cognitive function, particularly memory.