More than 80 per cent of Brits at risk of Alzheimer’s could miss out on revolutionary new drugs to treat the incurable disease, experts warned today.
Donanemab and lecanemab have both been proven to slow the progress of the memory-robbing illness in its early stages.
They are expected to be approved for NHS use later this year, with each already given the green light in the US.
But a lack of proper Alzheimer’s testing at scale means the health service risks being ‘overwhelmed’ by the demand for two new drugs, researchers argued.
Instead, the scientists from London estimated just 14 per cent of patients referred to clinics were actually likely to benefit from the treatments.
The two drugs have been proven to slow progression of the disease by as much as 60 per cent in trials by helping to remove the build up of the protein amyloid in the brain.
Experts have long believed they could herald a new era of dementia treatment by tackling the cause rather than just alleviating symptoms.
Currently, the only available drugs for Alzheimer’s are to treat symptoms.
The researchers, from University College London (UCL) and Queen Mary University, London, examined clinical notes from 1,017 NHS patients in the city, including 517 patients assessed in memory services and 500 in a specialist cognitive service.
Just under two thirds (62 per cent) of patients in specialist clinics received the necessary fluid biomarker tests.
Once those who would not be eligible for the treatments because of frailty and other issues were accounted for, they found four in ten were potentially eligible for treatment with the new drugs.
The scientists said this was equivalent to just 14 per cent of all cases — or one in seven — reviewed at specialist cognitive clinics.
By comparison, just a third (32 per cent) of patients in memory services were likely to be referred as potential candidates for the drugs.
Nearly all had undergone brain scans but only two patients were given lumbar punctures — which confirm if a patient had amyloid and tau proteins, associated with Alzheimer’s.
Writing in the Journal of Neurology, Neurosurgery and Psychiatry, researchers said there was a ‘clear and urgent’ need to improve NHS screening to work out who may benefit from new Alzheimer’s drugs.
Health service systems ‘need to be set up to deal with this potential large mismatch between referral and ultimate eligibility in order to avoid overwhelming services’, they added.
In April, it was revealed around 5,000 Brits could get cheap blood tests to spot Alzheimer’s in efforts to revolutionise ‘shocking’ NHS diagnostic rates.
Under two landmark trials, researchers from Oxford and University College London are set to use tests to detect proteins in the blood linked to the disease.
At the time, researchers said they hoped the ‘groundbreaking’ blood test, which costs around £100, could speed up the process, allowing patients to get treated earlier
The trials, which are expected to cost about £10million, are set to take place across the UK and will be carried out with people who have reported symptoms to their GP and who may be in the early stages of dementia.
David Thomas, head of policy and public affairs at Alzheimer’s Research UK, today said cheaper, more scalable diagnostics such as blood tests, were urgently needed.
He 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 report published earlier this year by NHS England said ‘timely diagnosis of dementia is vital’, adding new blood tests could soon replace lumbar punctures in diagnosing the disease.
It predicts the number of patients who might be eligible for the drugs ranges from 50,000 to 280,000, at an estimated cost of £500million and £1billion per year.
However, actual costs will depend on the drugs prices agreed for England.
The document said: ‘To be eligible for treatment, patients will need to have a baseline MRI scan and then either a PET-CT scan or lumbar puncture that confirms the presence of beta-amyloid proteins in the brain, which are associated with the Alzheimer’s disease process.’
Dr Alex Osborne, policy manager at the Alzheimer’s Society, said: ‘These drugs are only available to people in the early stages of Alzheimer’s disease – and more than a third of the 982,000 people living with dementia in the UK don’t have a diagnosis at all.
‘That’s why Alzheimer’s Society is calling on the NHS to publish plans on how it will deliver groundbreaking new treatments to the people who need them, with a specific focus on diagnosis and investment in the tools and workforce needed to identify eligible patients.’
Around 944,000 in the UK are thought to be living with dementia, while the figure is thought to be around 7million in the US.
Alzheimer’s affects around six in 10 people with dementia.
It is thought to be caused by a build-up of amyloid and tau in the brain, which clump together and from plaques and tangles that make it harder for the brain to work properly.
Eventually, the brain struggles to cope with this damage and dementia symptoms develop.
Memory problems, thinking and reasoning difficulties and language problems are common early symptoms of the condition, which then worsen over time.
Dementia are expected to sky-rocket in the coming years, making a cheap screening tool vital to get to grips with the challenge.
Alzheimer’s Research UK analysis found 74,261 people died from dementia in 2022 compared with 69,178 a year earlier, making it the country’s biggest killer.
Donanemab and lecanemab (pictured), have both been proven to slow the progress of the memory-robbing illness in its early stages. They are expected to be approved for NHS use later this year, with each already given the green light in the US
The two drugs have been proven to slow progression of the disease by as much as 60 per cent in trials by helping to remove the build up of the protein amyloid in the brain. Experts have long believed they could herald a new era of dementia treatment by tackling the cause rather than just alleviating symptoms
Alzheimer’s disease is the most common cause of dementia. The disease can cause anxiety, confusion and short-term memory loss
Source: Mail Online
