The Latest in Testing and Treatments for Alzheimer’s Disease

March 1, 2023 | Author: Deppe Fredbeck & Yount LLP

Alzheimer’s disease is the most common form of dementia. This disease gradually destroys memory and other mental functions that cause confusion. Many of us have a friend, family member, or know of someone that has been diagnosed. The medical community continues to search for ways to relieve symptoms, test for early signs, and find a cure.

Testing for Earlier Diagnosis

Studies have shown that changes in learning and memory happen well before signs of Alzheimer’s are found in brain scans. Early detection could offer an opportunity for preventative treatment in the future.

The US Food and Drug Administration (FDA) has authorized the first in vitro diagnostic for early testing of Alzheimer’s disease. It is an alternative to (PET) scans that use radiation and cerebrospinal fluid taps that are costly and time-consuming.

In May 2022, Fujirebio Diagnostic developed a new testing application for patients 55 years and older who have shown cognitive impairment. The test was able to get through an expedited review process. It can be used to detect brain plaques and analyze spinal fluid and proteins that accumulate to form the amyloid-beta plaques tied to Alzheimer’s disease. The FDA suggests testing be combined with other clinical evaluations to confirm a diagnosis.

Doctors and Medical Labs Evaluate the Future of Alzheimer’s

Most primary care doctors believe that one day, dementia will be managed as a chronic disease. But that means doctors and patients need to be made aware of new treatments and technologies, like the test developed by Fujirebio Diagnostic.

A survey by the Harris Poll for Quest Diagnostics suggests half of physicians don’t think Alzheimer’s will ever be cured, but about 75% thought new therapies might help manage the disease. Quest introduced a blood test in March for the early detection of Alzheimer’s. The company wants to see physicians and patients begin to prepare for the newer, more convenient diagnostics to become widespread tools in the health care industry.

New Alzheimer’s Drugs that Change Disease Progression and Relieve Symptoms

The FDA approved the first treatment to slow the progression of Alzheimer’s disease, aducanumab (Aduhelm), in 2021, although at least at first, Medicare will only cover patients participating in clinical trials. This drug may benefit both cognition and function. A second drug, Lecanemab (Leqembi), also designed to slow the progression of the disease, received accelerated FDA approval in January of 2023. It has not been announced whether Medicare will cover the cost of this drug.

Other medications are available but only treat symptoms:

  • Cholinesterase inhibitors like Donepezil, Rivastigmine, and Galantamine are prescribed to treat symptoms related to memory, language, judgment, and other thought processes at different stages of the disease.
  • Glutamate regulators like Memantine can improve memory, reason, language, attention, and the ability to perform simple tasks. Some of these drugs are used in combination for moderate to severe Alzheimer’s disease.
  • Orexin receptor antagonists like Suvorexant can help with insomnia in Alzheimer’s patients.

Quest reports that more than 100 disease-modifying therapies are now in clinical trials, with nearly 20 in later stages. With all the new technology to help physicians evaluate patients’ Alzheimer’s risk and disease progression, the future of Alzheimer’s may change from a debilitating illness to a manageable one. For those of us who have friends or family members with the disease, there is hope to slow the development and better manage the symptoms.

Sources:

https://n.neurology.org/content/94/4/e397

https://www.mcknights.com/news/clinical-news/fda-first-of-its-kind-diagnostic-test-for-alzheimers-gets-green-light/

https://www.raps.org/news-and-articles/news-articles/2022/5/first-in-vitro-diagnostic-for-early-alzheimers-det#:~:text=On%204%20May%2C%20FDA%20announced,who%20have%20shown%20cognitive%20impairment

Managing Alzheimer’s as chronic disease will require clinician, patient education, docs say

Subtle cognitive problems may reveal Alzheimer’s far earlier than thought

First Alzheimer’s commercial blood test to detect amyloid beta hits the market

https://www.mcknights.com/news/clinical-news/cms-restricts-coverage-of-alzheimers-drug-aduhelm-to-clinical-trials/