Emerging Therapies for Early Alzheimer's Disease

Michael Rafii, MD, PhD


April 03, 2023

The onset of Alzheimer’s disease (AD) is characterized by subtle cognitive changes, often dismissed as normal aging.

In this ReCAP, Dr Michael Rafii from the Keck School of Medicine at the University of Southern California reports that patients are classified as having early AD if their cognitive symptoms are accompanied by an elevation of brain amyloid.

Until recently, there were no treatments for AD, but two FDA-approved agents are now available, and several others are in clinical trials.

Aducanumab and lecanemab have both been given accelerated FDA approval after showing a reduction of brain amyloid in clinical trials. Aducanumab showed a reduction of cognitive decline by about 22% and lecanemab by 27%.

Emerging therapies for AD include gantenerumab, which had disappointing results in clinical trials, and donanemab, which is now in a phase 3 study and is expected to meet its primary outcome.

Evidence gained from clinical trials indicates that patients in the early stages of AD are most likely to benefit from treatment. Consequently, Dr Rafii says, primary care physicians can play a key role in identifying early signs of AD. He reviews ways for physicians to assess patients for mild cognitive impairment in office. Finally, Dr Rafii discusses how ALZ-NET, the Alzheimer's network registry is being used to collect real-world evidence on the use of these drugs, their efficacy, and their safety.


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