A prominent childhood memory is of my grandparents living with and then dying from dementia. As is universal with dementia, there was a double blow: watching my grandparents lose their identity and seeing the suffering of those closest to them.
Consistent with the patterns in the trials of the other two drugs, this tells us that all groups in all these trials declined and the amount of decline that was avoided by taking the drug—in this case donanemab— was a lot smaller than the amount of decline that still occurred .
Regular scans will sometimes pick up these pathologies in dementia patients. And, indeed, one in 11 of those in the placebo group had evidence of bleeding, while one in 59 had swelling. For most people, these events were only detectable by MRI and not through showing any specific symptoms. However, the effects of this drug's damage to the brain, particularly the long-term effects, are unknown.Aducanumab was marketed in the U.S.
The donanemab trial suggested that treatment could end when brain scans showed sufficient amyloid clearance. But we don't know if amyloid will return after some time. Regular monitoring for amyloid recurrence and repeated bouts of treatment would add further costs. There are other impositions for patients: attending centers every two to four weeks for drug infusions and regular monitoring and worrying about side-effects.It is accepted that not all trial"efficacy" will convert into clinical"effectiveness" . This is concerning, because there's little wriggle room before the effects become undetectable. And, while this is the case for all diseases, Alzheimer's is likely to be an extreme example.
For every 10 patients that doctors thought might be eligible for these trials, seven or eight were rejected. People with brain pathologies other than amyloid, such as vascular damage or
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