Contributed by Joshua Grill, PhD
Since Wednesday’s announcement by Eisai and Biogen of positive topline Phase 3 results for their treatment lecanemab in early Alzheimer’s disease, the field has been markedly aligned. Most agree that we need to see the data but that this seems to be a clear win and an important step in a positive direction.
Some debates have begun, and more will happen, about the size and meaning of the win—that is, the size of the drug’s disease-slowing effects and the clinical meaningfulness. These debates will be extremely important but will take time.
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 need to be started early in disease. Thankfully the field is engaged in prevention trials of promising monoclonal antibodies that are currently recruiting people with no memory problems at all, including the AHEAD study that features Eisai’s lecanemab and is enrolling at UCI MIND.
Trials such as the AHEAD Study test an important hypothesis—that lowering amyloid levels in the brain before symptoms even begin can delay or even prevent their onset. Starting treatments as early as possible aims to slow disease when damage is minimal, and at a time when even small effects could produce large long-term benefits.
Another landmark study of an ant-amyloid antibody as a potential prevention, the A4 Study, is set to conclude 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 has had many dedicated volunteers at UCI MIND, now for many years, who are committed to helping answer these important questions.
It is 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. There is much to work that still needs to be done, however. The faculty and staff of UCI MIND are poised to contribute significantly to this work, and to help share these exciting results with the public.