Only 1 per cent of dementia patients tested for new Alzheimer’s drugs

LONDON: Only 1 per cent of dementia patients get tests at that would allow them to access revolutionary new Alzheimer’s drugs, research has found.

Two breakthrough drugs, called donanemab and lecanemab, have been proven to slow the progress of Alzheimer’s disease in its early stages. They are expected to be approved for NHS use this summer, and up to 280,000 patients in the UK will be eligible.

However, patients need “gold-standard” diagnostic tests in the early stage of the disease to benefit. This involves either PET [positron emission tomography] brain scans or spinal fluid tests, to confirm the build-up of toxic proteins in the brain.

Research led by Queen Mary University of London has shown that only a handful of patients seen at NHS memory clinics are offered these tests, highlighting a “clear and urgent” need to improve screening before the drugs are launched.

Researchers from several NHS trusts examined the clinical notes from 1,017 patients with dementia in five areas of London. Half of these were referred to community memory clinics, the main dementia care and diagnostic service offered by the NHS.

The study, published in the Journal of Neurology, Neurosurgery and Psychiatry, found that 32 per cent of patients in memory clinics may be suitable for the Alzheimer’s drugs. However, less than 1 per cent of these had undergone the biomarker tests that are needed to get started on the new drugs.

The tests were more widely available at specialist NHS centres, but only a small proportion of dementia care is provided through these specialist centres. The study said new specialist NHS services must be urgently set up to prevent a “large mismatch” between referrals for the new drugs and those who can get them.

More than 900,000 people in the UK have dementia, and Alzheimer’s disease is the leading cause. Both donanemab, manufactured by Eli Lilly, and lecanemab, manufactured by Eisai/Biogen, work by finding and removing toxic clumps of amyloid proteins, which build up in the brains of patients with Alzheimer’s.

Trials have showed that the drugs slow the progression of memory loss by one third when given in the early stages, although potentially life-threatening side-effects, including brain bleeds and swelling, have been reported.

David Thomas, head of policy and public affairs at Alzheimer’s Research UK, said: “New Alzheimer’s drugs are finally on the horizon, but for their full potential to be realised, health systems need to be able to offer people with symptoms of dementia an accurate and early diagnosis to find out whether these treatments could benefit them. As this research demonstrates, the NHS is a long way from being able to do this testing routinely.

“Whoever forms the next government must invest in the NHS urgently, to ensure we have the right diagnostics and workforce in place to help identify people who could benefit from new treatments should they be deemed safe and effective by the regulators.

“A key part of the solution is cheaper, more scalable diagnostics, such as blood tests, for use in clinical care.”

A report published this year by NHS England said that “timely diagnosis of dementia is vital”. It put the costs of implementing the new drugs — if they are approved — at about £500 million and £1 billion a year.

The document said the estimated number of patients who might be deemed eligible for the drugs ranges from 50,000 to 280,000.