Anti-Alzheimer’s drugs can provide some benefits, but their effectiveness varies depending on the type of drug and the stage of the disease.
Symptomatic drugs (like cholinesterase inhibitors—donepezil, galantamine, rivastigmine—and memantine) can temporarily improve or stabilize memory, thinking, and daily functioning for some people, particularly in early to moderate stages.
These drugs do not slow the underlying progression of Alzheimer’s disease.
Their effects are modest, typically restoring memory to a level seen six to twelve months earlier, and the benefits only last as long as the medication is taken.
Newer drugs (such as lecanemab/Leqembi and donanemab) target amyloid plaques, a hallmark of Alzheimer’s.
A secondary analysis of the 1,582-patient TRAILBLAZER-ALZ 2 trial, reports an association between amyloid plaque levels on PET scans following donanemab therapy and cognitive decline, with a lighter plaque burden linked to a slower decline in volunteers over a 76 week period.
Lower amyloid levels correlated with slower clinical progression measured using both the integrated Alzheimer’s Disease Rating Scales.
There was also a correlation between parallel dips in blood biomarkers like plasma p-tau217, p-tau181 and glial fibrillary acidic protein and post-treatment amyloid plaque levels; no such correlation was observed for neurofilament light chain.
Initial results from the TRAILBLAZER-ALZ 2 trial has shown a roughly 25% overall slowing in clinical progression with donanemab versus placebo; the new work suggests that amyloid plaque removal is the donanemab’s mechanism of action rather than a cosmetic by-product.
Clinical trials show they can slow the rate of cognitive decline by about 30–35% over 18 months in people with early-stage disease, but they do not cure Alzheimer’s or reverse existing symptoms.
Such benefits are only seen in people with mild symptoms and are not guaranteed for everyone.
Side effects and eligibility restrictions-lecanemab, can cause brain swelling or bleeding?
None of the available drugs stop, cure, or reverse Alzheimer’s disease.