Japanese pharmaceutical firm Eisai Co plans to seek full approval of its experimental Alzheimer's drug lecanemab in the United States, Europe and Japan armed
with data showing it can slow the brain-wasting disease for people with early symptoms, potentially getting the treatment to patients next year.
It remains unclear how widely the drug developed with U.S. biotech Biogen Inc will be used due to uncertainty over insurance coverage, including the U.S.
government's Medicare plan for people age 65 and over, potential side effects and cost.
One Wall Street analyst told Reuters news agency that he is not counting on measurable sales until 2024. Several estimated lecanemab may be priced at around $20,000
per year.
"Most people who this (drug) would apply to are on Medicare, and most private payers look to Medicare as they make their own (coverage) decisions. So there's a
massive roadblock in the way of all who could benefit from this treatment," said Robert Egge, Alzheimer's Association chief public policy officer.
Eisai confirmed on Tuesday (November 30) that lecanemab - an antibody designed to remove sticky deposits of a protein called amyloid beta from the brain - reduced
the rate of cognitive decline on a clinical dementia scale by 27% compared to a placebo. It also gave new details on side effects including a dangerous type of brain
swelling and brain bleeding.
An experimental Alzheimer's drug developed by Eli Lilly and Co slowed cognitive decline by 35% in a late-stage trial, the company said on Wednesday, providing
what experts say is the strongest evidence yet that removing sticky amyloid plaques from the brain benefits patients with the fatal disease.
Lilly's drug, donanemab, met all goals of the trial, the company said. It slowed progression of Alzheimer's by 35% compared to a placebo in 1,182 people with
early-stage disease whose brains had deposits of two key Alzheimer's proteins, beta amyloid as well as intermediate levels of tau, a protein linked with disease
progression and brain cell death.
The study also evaluated the drug in 552 patients with high levels of tau and found that when both groups were combined, donanemab slowed progression by 29% based
on a commonly used scale of dementia progression known as the Clinical Dementia Rating Scale (CDR-SB).
Using that scale, experts said Lilly's findings were roughly on par with Eisai Co Ltd and Biogen Inc's lecanemab, sold under the brand name Leqembi, which reduced
cognitive decline by 27% in patients with early Alzheimer's in a study published last year.
The results drove Lilly's shares to a record high, up more than 6% at $429.85.
Dr. Ronald Petersen, an Alzheimer's researcher at Mayo Clinic, said Lilly's trial is the third to show removing amyloid from the brain slows progression of the
disease, which could put to rest some lingering doubts about the benefits of drugs in the class and the amyloid-lowering theory.
"It's modest, but I think it's real," he said of the benefit, "and I think it's clinically meaningful."
Dr. Erik Musiek, a Washington University neurologist at Barnes-Jewish Hospital, said the efficacy looks as good or better than lecanemab.
Dementia is an extremely deceptive disease that develops slowly and may go unnoticed in people, said NHS mental health director Claire Murdoch, while
urging people to look out for the vital warning signs of this condition among family and friends over Christmas.
Common early symptoms of dementia may include emotional change, forgetfulness, difficulty concentrating, struggling to follow a conversation or find the right word,
being confused about time and place, the health service has cautioned.
An increasing number of people have been diagnosed with dementia in England since the start of the pandemic, following a drive by the NHS England to increase
diagnosis rates.
In November 2023, NHS staff diagnosed 463,797 people aged over 65 with dementia, up more than 41,000 compared to the same period last year, according to the
figures revealed by the health service.