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Dementia breakthrough drugs could be a golden opportunity

There are over 120 drugs being tested in clinical trials, and two, lecanemab and donanemab, have made headline news as the UK’s first-ever approved drugs for treating early-stage Alzheimer’s disease, although they’re not available on the NHS.  

Richard Oakley, Associate Director of Research and Innovation at Alzheimer's Society, commented on the future of dementia diagnosis. 

“The full results are out and the science behind them is solid – dependent on the memory test used, the drug can slow down Alzheimer’s disease by more than 20% and by as much as 60% if given to people at the earlier stages of the disease.

It also meant participants were able to carry out everyday tasks such as driving and managing finances for longer.”

How do these treatments work and when will they be available?

Both lecanemab and donanemab are monoclonal antibodies. They’ve both been proven in trials to reduce the amount of amyloid protein present in the brain of people with early-stage Alzheimer’s disease, and slow down the decline in memory and thinking skills – lecanemab by 27%.

Existing treatments for dementia help to manage symptoms, but they don’t tackle the underlying causes of the disease. But by using the body's immune system, these new drugs actively slow down the progression of the disease.

For these drugs to be available on the NHS, they need to be approved by NICE (National Institute for Health and Care Excellence) and, at the time of writing, that hasn’t happened.

Consultation is ongoing, but one issue is diagnosis. Disease-modifying drugs like lecanemab rely on early diagnosis, because they’re only effective in early Alzheimer’s disease. Right now, it’s estimated that more than a third of people over 65 who are living with dementia in England go undiagnosed.  

Early and accurate dementia diagnosis 

The innovation in diagnosis research sits directly alongside the need for breakthrough drugs – and has led to some incredible discoveries that could dramatically change lives.    

Richard Oakley notes that, “Clinical trial results for both drugs have shown that the patients most likely to benefit are those in the early stages of the disease.

We need to be able to diagnose people much earlier than we currently do – currently only around 63% of people get a diagnosis and estimates are that most people get a diagnosis at the moderate or severe, rather than mild, stage.

"The problem is that all too often people are getting a fuzzy diagnosis of ‘dementia’ rather than the specific disease of the brain causing their dementia. A revolution in diagnosis is needed.”

Improving diagnosis with The Blood Biomarker Challenge

In April 2023, we joined forces with Alzheimer’s Research UK and the National Institute of Health and Care Research to launch the Blood Biomarker Challenge – with the aim of revolutionising the way dementia is diagnosed. The project aims to gather the information needed to roll out a blood test for dementia in clinics.  

A blood-based biomarker is an indicator in the blood that can be tested to detect whether someone has a disease, or is at risk of developing it. Two incredible teams of scientists are taking part in our challenge, led by dementia research experts Professor Jonathan Schott and Professor Vanessa Raymont.  

Blood tests for Alzheimer’s disease do exist, but evidence is needed to show that they can work for patients in the real world. The work done by these world-class research teams could lay the path for NHS tests to transform dementia diagnosis.  

Fiona Carragher, Chief Policy and Research Officer, commented,

“This is ground-breaking, system-shaking research with the potential to completely overhaul the way we diagnose dementia.” 

Preparing for new dementia treatments 

We need to give clinicians better diagnostic tools so they can give an early and accurate diagnosis. We know blood tests can diagnose Alzheimer’s disease in the lab – now we need to get them tested in a UK clinical setting with the hope of rolling blood tests out within the next 4-5 years.

In addition, we need a high-profile public awareness campaign so that more people come forward for a diagnosis early on. 
Investing in dementia research  

Since dementia was identified over 100 years ago, the endeavour of research has been to find a drug which will slow the progression of these devastating diseases.

Although dementia is expected to affect 1 in 3 people born today, investment in dementia research lags behind other conditions, such as cancer and heart disease. 

Now is the time to create the sense of urgency that dementia has lacked. We cannot let people down.