- Tens of thousands protest in Serbian capital over fatal train station accident
- Trump vows to 'stop transgender lunacy' as a top priority
- Daniels throws five TDs as Commanders down Eagles, Lions and Vikings win
- 'Who's next?': Misinformation and online threats after US CEO slaying
- Only 12 trucks delivered food, water in North Gaza Governorate since October: Oxfam
- Langers edge Tiger and son Charlie in PNC Championship playoff
- Explosive batsman Jacobs gets New Zealand call-up for Sri Lanka series
- Holders PSG edge through on penalties in French Cup
- Slovak PM Fico on surprise visit to Kremlin to talk gas deliveries
- Daniels throw five TDs as Commanders down Eagles
- Atalanta fight back to take top spot in Serie A, Roma hit five
- Mancini admits regrets over leaving Italy for Saudi Arabia
- Run machine Ayub shines as Pakistan sweep South Africa
- Slovak PM Fico on surprise visit to Kremlin
- Gaza rescuers say Israeli strikes kill 35
- 'Incredible' Liverpool must stay focused: Slot
- Maresca 'absolutely happy' as title-chasing Chelsea drop points in Everton draw
- Salah happy wherever career ends after inspiring Liverpool rout
- Three and easy as Dortmund move into Bundesliga top six
- Liverpool hit Spurs for six, Man Utd embarrassed by Bournemouth
- Netanyahu vows to act with 'force, determination' against Yemen's Huthis
- Mbappe back from 'bottom' as Real Madrid down Sevilla
- Ali hat-trick helps champions Ahly crush Belouizdad
- France kept on tenterhooks over new government
- Salah stars as rampant Liverpool hit Spurs for six
- Syria's new leader says all weapons to come under 'state control'
- 'Sonic 3' zips to top of N.America box office
- Rome's Trevi Fountain reopens to limited crowds
- Mbappe strikes as Real Madrid down Sevilla
- 'Nervous' Man Utd humiliated by Bournemouth
- Pope again condemns 'cruelty' of Israeli strikes on Gaza
- Lonely this Christmas: Vendee skippers in low-key celebrations on high seas
- Troubled Man Utd humiliated by Bournemouth
- 2 US pilots shot down over Red Sea in 'friendly fire' incident: military
- Man Utd embarrassed by Bournemouth, Chelsea held at Everton
- France awaits fourth government of the year
- Germany pledges security inquest into Christmas market attack
- Death toll in Brazil bus crash rises to 41
- Joshua bout only fight left for beaten Fury says promoter Hearn
- Odermatt stays hot to break Swiss World Cup wins record
- Neville says Rashford's career at Man Utd nearing 'inevitable ending'
- Syria's new leader vows not to negatively interfere in Lebanon
- Germany pledges security inquest after Christmas market attack
- Putin vows 'destruction' on Ukraine after Kazan drone attack
- Understated Usyk seeks recognition among boxing legends
- France awaits appointment of new government
- Cyclone Chido death toll rises to 94 in Mozambique
- Stokes out of England's Champions Trophy squad
- Gaza rescuers say Israeli strikes kill 28
- Sweet smell of success for niche perfumes
Revolution or mirage? Controversy surrounds new Alzheimer's drugs
Two new drugs, the first capable of slowing down the debilitating progression of Alzheimer's disease, have become embroiled in one of the biggest medical controversies in recent years.
For their defenders, the drugs lecanemab and donanemab represent the first real chance to fight the disease after decades of research -- for detractors, they are another disappointment after a long line of costly failures.
"We have turned a corner" thanks to these treatments, British biologist John Hardy, who has been studying Alzheimer's since the 1990s, told AFP.
Rob Howard, a professor of old age psychiatry at University College London, was on the other side.
"I think that the drugs have been used to raise false and unrealistic hopes in people with Alzheimer's disease and their families," he said.
These opposing statements sum up the entrenched positions on the recently introduced drugs for Alzheimer's, the most common form of dementia which millions of people across the world suffer from.
Lecanemab, sold under the name Leqembi, was developed by US pharma firms Biogen and Eisai. Donanemab, developed by pharma giant Eli Lilly, is sold as Kisunla.
The controversy has seen countries take different stances on whether to approve the drugs or not.
The United States gave the green light to lecanemab in 2023, then donanemab earlier this year.
However the European Union rejected lecanemab in July, a bad omen for donanemab's chance of approval.
Last month, the UK steered a middle course, approving the use of lecanemab but not making it available on the state National Health Service.
What no one denies is that the two drugs are the most effective Alzheimer's treatments ever -- but their effectiveness is limited.
Both appear to reduce cognitive decline in patients at the onset of their disease by around 30 percent.
While that may seem high, it represents a relatively small difference over the year-and-a-half period when the studies were carried out.
"The benefits are so tiny as to be practically invisible in an individual patient," Howard said.
- Exorbitant cost -
For critics, there are not enough benefits to outweigh the risks of the drugs, which can sometimes cause brain swelling or bleeding that in rare cases has proved fatal.
And they are very expensive. At the prices being charged by Biogen and Eisai in the United States, lecanemab would cost 133 billion euros ($148 billion) if given to all eligible patients in the EU, according to a 2023 study.
Advocates of the drugs, including many neurologists, believe they can offer patients a few more precious months of autonomy.
They also believe that the effectiveness of the drugs could be multiplied if patients started taking them earlier in the disease's progression. This could soon be more practicable as research on diagnosing Alzheimer's more quickly has recently been making significant strides.
The differing national policies could also mean that poorer patients are left behind.
"We will see rich people going to the US" for the drugs, Hardy said.
The debate can be traced back in part to a seminal 1992 article by Hardy about how the disease actually works.
The article argues that clumps of protein called amyloid plaques -- a constant in the brains of Alzheimer's patients -- are not just one element among others, but the main factor triggering the disease.
Over the decades, many drugs targeting these amyloid plaques were developed, all of which failed -- until lecanemab and donanemab.
- Pressure from families -
The scepticism from some quarters about the new drugs could be because the previous ones were defended and even lauded by some, despite their ineffectiveness.
Christian Guy-Coichard, the head of French organisation Formindep which monitors medical conflicts of interest, accused Alzheimer's groups, researchers and pharmaceutical firms of being too close.
But France Alzheimer deputy director Benoit Durand said that very little of its funding came from Biogen/Eisai or Eli Lilly, instead pointing towards pressure for new treatments from patients' families.
"They don't understand" the EU's decision to turn down a breakthrough new drug, Durand told AFP. He also feared that laboratories could lose interest in Alzheimer's disease due to the setbacks.
Even within the pharmaceutical industry, some admit that past failures have not necessarily helped build trust.
A doctor working for Eli Lilly, who spoke on condition of anonymity, blamed its rival Biogen for overstating the benefits of previous treatment Aduhelm. The drug was controversially approved in the US in 2021 before being withdrawn.
"The Aduhelm studies were a mess," the doctor said.
The aftermath "did a lot of harm and sowed chaos in the discipline", the doctor added, pointing the finger at Biogen.
In response, Biogen told AFP that it was complying with "the principles of scientific research as well as legal and regulatory requirements".
But the Eli Lilly doctor defended the new treatments all the same, urging people to look to the future, not the past.
Like other specialists, he also acknowledged that other mechanisms besides amyloids that could be behind Alzheimer's need to be explored.
Given the disease's complexity, it is unlikely that "single-target treatments will achieve substantially larger effects" than lecanemab and donanemab, a group of experts wrote in the Journal of Prevention of Alzheimer's Disease last month.
But the new drugs are a "critical step" in Alzheimer's treatment, they added.
L.Harper--AMWN