What is the dementia drug donanemab?

Donanemab: A potential game-changer in the battle against Alzheimer’s Disease

In the world of Alzheimer’s research, a promising drug candidate known as donanemab is making waves. This innovative drug, developed by pharmaceutical titan Eli Lilly, aims to slow cognitive deterioration associated with early stages of Alzheimer’s (either mild cognitive impairment or mild dementia), offering a glimmer of hope in the battle against this devastating disease.

Understanding Alzheimer’s Disease

Alzheimer’s Disease is the most common form of dementia, affecting millions of people worldwide. It is characterised by the build-up of two types of proteins in the brain – beta-amyloid and tau. These proteins form plaques and tangles, respectively, which disrupt brain cells’ function, leading to symptoms such as memory loss, confusion, and problems with speech and understanding.

Donanemab: A new approach

Donanemab provides a fresh approach to tackling this disease. It is an antibody therapy that targets aberrant clumps of the beta-amyloid protein. By binding to and removing these clumps, the drug aims to reduce brain damage and slow cognitive decline and disease progression.

How does Donanemab work?

Administered intravenously, alzheimer’s drug donanemab works as an immunotherapy drug. It trains the body’s immune cells to recognise and eliminate the harmful amyloid proteins that build up in the brain of Alzheimer’s patients. As these protein deposits are thought to be toxic to brain cells, their removal could potentially slow the disease’s progression.

Success in clinical trials

Clinical trial data indicates that donanemab can clear nearly 90% of amyloid plaque from the brain. It does not halt the disease’s progression or improve patients’ condition, but it does slow their deterioration.

In the 1,736-person trial, donanemab reduced mental decline by 35% in some participants. This significant result is comparable to that for lecanemab, another competing drug.

Who can benefit from Donanemab?

The drug appears to be most beneficial for patients in the earliest stages of Alzheimer’s disease and those with low levels of the tau protein in their brains. The removal of amyloid proteins before tau spreads seems crucial in slowing the disease’s progression.

Comparing Donanemab with other drugs

Donanemab isn’t the only drug targeting amyloid proteins. Lecanemab, an antibody therapy developed by Eisai, a Japanese pharmaceutical company, works similarly. Earlier this year, the US Food and Drug Administration (FDA) gave lecanemab accelerated approval. Another drug called aducanumab was approved by the FDA in 2021. Donanemab Mops Up Plaque Faster Than Biogen’s Aduhelm.

Potential side effects of Donanemab

Like all drugs, donanemab has associated side effects. These include headaches, reactions to the intravenous drip, and brain swelling or microbleeds linked to amyloid. Most side effects were either mild or detected in tests but didn’t cause symptoms. However, 0.4% of participants died due to brain swelling, and 1.6% had serious symptoms related to it.

Addressing the risks

Despite the potential benefits, donanemab’s side effects cannot be overlooked. In the Eli Lilly trial, about a quarter of the patients experienced some level of brain swelling or bleeding, though serious problems were rare. Four people died while participating in the trial – three from the donanemab group and one from the control group.

Looking forward

While donanemab is not a cure for Alzheimer’s, the drug represents a significant breakthrough in the fight against the disease. Its ability to slow cognitive decline, albeit modest, suggests that we may soon have a suite of drugs, each targeting a different aspect of the disease, to halt cognitive decline.

Despite the optimism surrounding donanemab, questions remain. The drug’s long-term effects are still unknown, and the risk of harmful side effects cannot be ignored. Still, as the world continues its battle against Alzheimer’s disease, donanemab represents a promising step forward.

The future of Alzheimer’s treatment

While donanemab offers hope, it is essential to remember that it is not a cure. It represents only one of many potential strategies in the battle against Alzheimer’s. The success of this drug strengthens the conviction that early detection and treatment could change the trajectory of this devastating disease.

The Impact on Alzheimer’s research

The full analysis from the study indicates that the results were less robust for older, later-stage patients and those with higher levels of the tau protein. This underscores the importance of early detection and diagnosis in changing the disease’s trajectory.

The next steps

As we move forward, researchers will continue to study donanemab and other similar drugs. They will monitor patients’ progress, assess potential side effects, and strive to understand how these drugs can best be used in the fight against Alzheimer’s. The journey may be long and fraught with challenges, but the potential rewards — the ability to slow or even halt the progression of Alzheimer’s — are immense.

Sources

• Donanemab in Early Symptomatic Alzheimer Disease – Jama Network
• Alzheimer’s drug donanemab: what promising trial means for treatments – Nature
• What is donanemab? – Alzheimer’s Society
• What impact will Alzheimer’s drug donanemab have? – The Guardian
• Donanemab – Alzforum
• Lilly drug slows Alzheimer’s by 60% for mildly impaired patients in trial – Reuters
• Drug donanemab seen as turning point in dementia fight – BBC
• Amyloid-related imaging abnormalities – Wikipedia.org