Third FDA-approved Alzheimer’s drug can give patients more time with family

Alzheimer’s patients can temporarily lessen their symptoms with a recent FDA-approved drug that removes amyloid, or protein, plaques in the brain.

The drug, donanemab, was developed by pharmaceutical company Eli Lilly and is marketed under the name Kinusla. It was approved on July 2 and is the third infusion-based drug to slow symptoms, said Kay Lehmann, Washington State Alzheimer’s Association board chair. The first, which was released in 2021, was taken off the market because of complications. Lecanemab, released in 2023, is now being infused in Alzheimer’s patients in Washington state.

The new medication will help with tangles and amyloid plaques developed in the brain when someone has Alzheimer’s, she said.

“We still don’t know for sure if they are the cause of Alzheimer’s or they’re the result of the disease process, but as they’re cleared up with these drugs, it seems to help people’s functioning,” Lehmann said.

The amyloid plaques can cause protein deposits in the brain, but medicine put in the brain to help drain the plaque can help the memory for someone who has Alzheimer’s symptoms, such as changes in behavior, cognition and mood, said Arifulla Khan, medical director of Bellevue Northwest Medical Research Center.

Khan, who helped work on the clinical trials for donanemab, said the drug will be administered through infusions and intermuscular methods under the skin in the muscle or blood stream. The medicine will then affect the particular organ and protein impacted by Alzheimer’s disease and disables it.

Donanemab helps clear the amyloid protein from the brain and previous studies have shown that it helps with people’s cognitive and behavioral effects of early Alzheimer’s disease, Khan said.

But there is always the possibility of complications when proteins are extracted from the brain, such as swelling, he said.

Khan has been involved with Alzheimer’s research for 25 years and said there is always a search for new medication because not every drug works or is safe for every person.

It needs to be proven that people have Alzheimer’s to have access to donanemab, said David Greeley, a Northwest Neurological clinical researcher who also worked on the clinical trials for the drug.

“There’s no reason to go on a drug that removes amyloid plaque unless you can know for sure that you have amyloid plaque,” Greeley said.

An amyloid PET scan can find the plaque, but Greeley said Medicare does not cover the entire cost of the scan.

But Medicare can cover the cost of a lumbar puncture in the area, he said. Once the procedure is completed by a neurologist, patients will receive a diagnosis and medical options including the FDA-approved drugs.

Donanemab is not a cure for Alzheimer’s but it does slow the disease, Greeley said.

“It’s disease modifying, so people who are on these drugs can be expected, on average, to have a lessening of the decline of their dementia over a lengthy time frame, roughly saving six months of decline over an 18-month period,” he said.

Lehmann said the medicine opens a longer time frame for people with Alzheimer’s patients to do what they need to do with their family.

“It’s going to let people have more healthy time to put their affairs in order … where they can safely live on their own and just live their life the way they would want to be living it before the disease progresses,” she said. “But this is not a cure. This does not completely stop the disease progression.”

Treatments need to begin when people are in the early stages of Alzheimer’s disease, and a common problem is people with the disease wait too long to get diagnosed, Lehmann said.

“People do need to get a pretty early diagnosis for these drugs to be effective,” she said.

Clinicians and primary care providers are important in an Alzheimer’s patient’s life, said Nicholas Hart, public policy manager for the Washington Alzheimer’s Association.

“These treatments only work in the early stages of the disease,” Hart said. “In a nutshell, I would like to … encourage folks to talk about memory loss with their doctor and anytime they’re considering any of these treatments, to also have this discussion with their primary care provider.”

The Alzheimer’s Association has support groups, education presentations for caregivers and other resources on its website, said Amie Northagen, marketing and communications manager.

A 24-hour help line is also available through the association to help answer questions about treatment or if someone is having trouble in their day-to-day life. Northagen said the helpline can be used even if someone just needs to talk because they are stressed.

“Not only are we looking to the future to find a cure for this disease, but we’re kind of asking the questions of how we can support people who are living with Alzheimer’s and their caregivers,” she said.