The emergence of disease-modifying therapies for Alzheimer’s disease (AD) has ushered in an “exciting” period for the treatment of the condition, according to Dr Antoinette O’Connor, Consultant Neurologist, Tallaght University Hospital, Dublin.
However, she said it is essential that patients are appropriately selected for these therapies.
Dr O’Connor delivered a lecture on the diagnosis and management of dementia at the Neurology Update Meeting 2024.
In her talk, Dr O’Connor stressed the value of early diagnosis and outlined recent developments in the field.
Speaking to the Medical Independent (MI) at the meeting, she said “there has been a huge amount of progress” in the area of diagnosis with the ability to test for and monitor cerebrospinal fluid biomarkers.
“Also, there is a lot of innovation in the field of blood biomarkers,” Dr O’Connor said.
“And that’s really exciting because they are more accessible, they are cheap, they are easily repeatable. Now they are not available clinically yet and there will need to be proper regulation and research about how they are implemented clinically. But they are definitely coming.”
In terms of treatment, she stated that the advent of disease-modifying therapies targeting the amyloid protein is “very exciting”.
“Removing amyloid has been consistently related to the slowing of cognitive decline,” Dr O’Connor said.
“For a long time, we have just had symptomatic therapies. But now we can actually have disease modification and that is exciting.”
She said the future promises greater biomarker-supported diagnosis and molecular-specific therapies.
Dr O’Connor said treatments targeting “additional elements” of AD pathophysiology, such as neuroinflammation and tau accumulation, will likely be needed to achieve a “more profound” impact on outcomes.
In her lecture, she pointed out that the treatment of AD could eventually mirror therapeutic developments in the field of multiple sclerosis (MS).
“With MS, many years ago, there weren’t disease-modifying therapies,” Dr O’Connor told MI.
“Now we have many disease-modifying therapies. And they’ve really evolved, so the first agents for MS are not often used now, or are rarely first-line, and we have all these other effective therapies. With these agents [for AD], the hope is in the future that we refine their mechanism, refine their delivery, and get even more targeted and effective therapies.”
Dr O’Connor stressed that patients needed to be carefully selected for the new therapies.
“Like all medications, they come with side-effects. We need to make sure that people are appropriately selected, that there is not an excessive risk of side-effects. Also, that the people are appropriate in that they are eligible to benefit.”
She added patients who are not eligible for the new treatments needed to receive adequate support and management of their condition.
Leave a Reply
You must be logged in to post a comment.