Impact of new Alzheimer’s drug contingent on early detection

July 18 2023

The impact of new treatments on patient desires

The newly approved drug for Alzheimer’s disease, Leqembi, has been making news since the FDA
announced its accelerated approval in January. In June, an advisory panel agreed that Leqembi does
provide benefit to patients, and on July 6, the FDA announced that is has granted traditional approval to
the treatment.

The expectations for the new drug, which was shown to slow cognitive decline by 27%, are high, and the
excitement among millions of Alzheimer’s patients and their families and caregivers is understandable.
But a crucial point about Leqembi and other treatments on the way is that they target patients within a
limited window at the early stages of Alzheimer’s disease. Leqembi is not indicated for people whose
dementia has progressed too far; it is approved for the early stages of mild cognitive impairment or mild
dementia. If a patient misses that treatment window, there is no turning back the clock.

Joanne Pike, DrPH, Alzheimer’s Association president and CEO, said that Leqembi “gives people in the
early stages of Alzheimer’s disease more time to maintain their independence and do the things they
love.” However, she told NPR in a July 6 article on the FDA’s announcement that “the U.S. healthcare
system simply isn't prepared to diagnose, treat, and monitor a large number of Alzheimer's patients.”

According to the Alzheimer’s Association, more than 2,000 people with early Alzheimer’s progress
outside of the treatment window every day without access to approved treatments. And CNBC reports
that research shows a potential wait time from 18 months to four years to receive a diagnosis and
treatment. During that time, many patients will miss out on the opportunity to benefit from Leqembi as
their Alzheimer's disease worsens.

Continued barriers to early detection and diagnosis of Alzheimer’s and other dementias, caused in large
part by a shortage of specialists and a lack of systematic cognitive testing, will prevent thousands if not
millions of patients from receiving the benefit of new drugs like Leqembi.

The growing role of primary care

Primary care providers are not only in the best position to pick up the early signs of mild cognitive
impairment and facilitate early intervention, but their role will also be increasingly essential as specialist
access becomes even more limited.

Implementing cognitive testing into routine visits for older adults, using innovative tools like digital
cognitive assessments, is a critical way to shorten the diagnosis timeline. AI-enhanced solutions can
even detect signs of mild cognitive impairment even before symptoms arise, empowering patients and
their families with more time to act and, if appropriate, gain access to treatments like Leqembi.
Ultimately, this could be the difference-maker when it comes to patients having a new opportunity to
slow disease progression and extend quality of life.

The success of Leqembi and other similar new drugs in the pipeline will rely on whether providers can
diagnose patients in time. It’s no exaggeration to say that early detection can change the lives of
patients and their families. Primary care providers can prepare for the changing needs of their older
adult patients – including rising demand for cognitive testing and treatment – and gain actionable tips for expanding cognitive care services in this practical guide to expanding cognitive screening and assessment.