How do you explain the clinical benefit of lecanemab or donanemab to patients?
Do you feel the study outcomes for anti-amyloid therapies are clinically meaningful?
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I do feel that the study outcomes are clinically meaningful, especially for patients with mild cognitive impairment due to AD. A clinically meaningful outcome is the ability to stay at an early symptomatic stage for a longer time than the natural history of the disease would otherwise allow. It appe...
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I generally start by telling patients that these medicines do not stop, reverse, or cure Alzheimer’s disease, but they do modestly slow the rate of progression when given early in the course of the disease. As a class, anti-amyloid antibodies seem to slow the rate of disease progression by about 30%...
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The therapeutic effect is so small and the medication is cumbersome and expensive that's it's not worth it for most people. I emphasize low hanging fruit like reversing metabolic syndrome, optimizing sleep, exercise, diet, and other lifestyle measures that will benefit not only their cognitive impai...
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