NEW HOPES and FEARS for ALZHEIMER'S PATIENTS

A new drug offers MODEST SLOWING of the disease in its early stages. But are the benefits worth THE RISKS?

- Meghan Gunn

AFTER MANY DECADES of little or no progress in treating the dementia associated with Alzheimer's, a new drug now offers hope to patients and caregivers. Lecanemab, announced late last month, was found in clinical trials to slow cognitive decline in early-stage Alzheimer's patients. "It's an extremely encouraging result," says Dr. David Wolk, co-director of the University of Pennsylvania's Penn Memory Center.

The arrival of lecanemab comes with some big caveats, however. The drug has significant health risks, including bleeding and brain swelling. It's expensive drug manufacturer Esai estimates the annual price of treatment would be somewhere between $9,249 and $35,605, and it's unclear what insurance will cover. And the drug has only a modest effect on the debilitating progress of Alzheimer's.

Some scientists are also having second thoughts about the strategy that led to lecanemab-namely, trying to slow Alzheimer's solely by inhibiting the buildup of beta-amyloid, a protein that accumulates in the brain cells to form plaques. After three decades of chasing one failed treatment after another and burning through billions of dollars in research funding, lecanemab is the first unequivocally successful plaque-inhibiting treatment for Alzheimer's. (A similar drug, Aduhelm, was approved last year by the U.S. Food and Drug Administration to some controversy.) Many scientists now think amyloid plaque is only one of many factors in causing the disease's debilitating effects and call for new approaches.

The FDA is expected to decide on an accelerated approval status for lecanemab on January 6, which would enroll additional patients in new trials. If those are successful, full approval would likely arrive late next year.