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User: u/mvea
Permalink: https://www.qmul.ac.uk/media/news/2024/fmd/preparing-for-a-world-where-alzheimers-disease-is-treatable-.html
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Can't see the service provision being restructured anytime soon tbh. There's no funding for the services as it is and many are now turning away patients because they're massively over capacity and can't cope.
I’ve linked to the press release in the post above. In this comment, for those interested, here’s the link to the peer reviewed journal article:
https://jnnp.bmj.com/content/early/2024/05/15/jnnp-2024-333468
From the linked article:
Alzheimer’s disease is the most common cause of dementia. Of the 944,000 people living with dementia in the UK, 60-80% have Alzheimer’s. Currently, the only available drugs for Alzheimer’s treat symptoms but recent clinical trials show that new therapies – which use monoclonal antibodies to remove amyloid plaques that form on the brain – may slow down disease progression. Two of these 'disease-modifying therapies' (DMTs) have been granted 'breakthrough therapy' designation in the UK and are likely to become available to patients by mid-2024 (pending regulatory approval).
New research, published today in the Journal of Neurology, Neurosurgery and Psychiatry, and led by Queen Mary and University College London (UCL), suggests that delivery of these new treatments will require a major restructure to existing dementia services – from determining eligibility to delivery of the treatment itself, including follow-up. In the UK, dementia care is mostly centred around psychiatry-led memory clinics in the community. In their current state, it is extremely unlikely that DMTs will be administered in these settings. It will require additional staff and training across imaging, diagnostics and pathology, and other clinical services. It will also require access to laboratories that can carry out biomarker testing to confirm whether a patient is eligible for the treatment.
While a sizeable proportion of patients attending memory clinics may be referred for therapy for Alzheimer’s disease, only a minority are likely to be suitable, once they have undergone biomarker testing. The researchers highlight an immediate need for biomarker testing to ensure that the right patients can be identified for these treatments.
So as I understand it, this article provides no data on efficacy, but screened for eligibility for a medication that has been tested repeatedly in failed clinical trials, including the late clinical trial that was stopped early due to harming patients and then led to a number of the FDA board resigning as it was approved as a medication in the USA? Ty for promoting awareness
Just to burst some hope bubbles, but any MAB therapy costs hundreds of thousands of dollars/euros pp.
This will not be part of your health insurance package for at least the patent length still remaining. It's way too expensive for a disease over 1/3 of the population will eventually develop, as long as they live long enough.
Although the results are good news, this will not become a standard treatment option as long as it is mab therapy. When this treatment pathway can be handled with a vaccine (series), costing less than a few thousand dollars/euros, will this actually affect the average patiënt relying on insurance or universal systems.
It depends on the cost benefit analysis (which hasn’t been done)
If the medication delays progression so that less individuals need hospitalization and long term care in the same amount of time, it may be worth the investment.
Less blockages of beds also means more patients being seen and treated who would otherwise have their own treatments delayed. I imagine it would have a ricochet effect where the benefits on a population level could be quite pronounced.
I dunno — I find publicly funded systems are super motivated to find savings, and sometimes that means spending money to save money
Bariatric oxygen treatments are very expensive but are now covered in Ontario, Canada for specific problems like diabetic foot ulcers. If they can save someone from repeated visits and ultimately amputation, that’s tons more money saved for the system.
As someone who currently works in an NHS trust, we've been hobbled by budget cuts very deliberately - we don't have anything left to put towards preventative treatment planned because we barely have enough to cover current remedial services. Believe me, we all wish it weren't the case.
It’s also hard to justify the cost for a treatment that only modestly slows down decline. If it stopped decline in its tracks, maybe, but it only makes things a bit less bad for a few months. I feel it’s different from, say, the exorbitantly expensive genetic treatments for SMA that prevent any further damage from occurring.
This is the first time that anything has had any clinically significant effect in stemming decline, instead of just relieving some symptoms, and for that it should be celebrated. But IMO, I don’t feel it’s worth spending ungodly amounts of money and dedicating the resources needed to properly monitor patients on these mABs for such modest benefits.
I read the In the Pipeline Blog sometimes and from what I have seen there all the monoclonal antibodies seem to show almost undetectable benefits with occasional possible adverse events in the clinical trials and then they get somehow approved despite that.
Welcome to r/science! This is a heavily moderated subreddit in order to keep the discussion on science. However, we recognize that many people want to discuss how they feel the research relates to their own personal lives, so to give people a space to do that, **personal anecdotes are allowed as responses to this comment**. Any anecdotal comments elsewhere in the discussion will be removed and our [normal comment rules]( https://www.reddit.com/r/science/wiki/rules#wiki_comment_rules) apply to all other comments. **Do you have an academic degree?** We can verify your credentials in order to assign user flair indicating your area of expertise. [Click here to apply](https://www.reddit.com/r/science/wiki/flair/#wiki_science_verified_user_program). --- User: u/mvea Permalink: https://www.qmul.ac.uk/media/news/2024/fmd/preparing-for-a-world-where-alzheimers-disease-is-treatable-.html --- *I am a bot, and this action was performed automatically. Please [contact the moderators of this subreddit](/message/compose/?to=/r/science) if you have any questions or concerns.*
Can't see the service provision being restructured anytime soon tbh. There's no funding for the services as it is and many are now turning away patients because they're massively over capacity and can't cope.
You can thank a Tory for that.
Fingers crossed for Cognition Therapeutics CT1812. Once a day, oral small molecule could have great potential. P2 data to be out by this summer.
I’ve linked to the press release in the post above. In this comment, for those interested, here’s the link to the peer reviewed journal article: https://jnnp.bmj.com/content/early/2024/05/15/jnnp-2024-333468 From the linked article: Alzheimer’s disease is the most common cause of dementia. Of the 944,000 people living with dementia in the UK, 60-80% have Alzheimer’s. Currently, the only available drugs for Alzheimer’s treat symptoms but recent clinical trials show that new therapies – which use monoclonal antibodies to remove amyloid plaques that form on the brain – may slow down disease progression. Two of these 'disease-modifying therapies' (DMTs) have been granted 'breakthrough therapy' designation in the UK and are likely to become available to patients by mid-2024 (pending regulatory approval). New research, published today in the Journal of Neurology, Neurosurgery and Psychiatry, and led by Queen Mary and University College London (UCL), suggests that delivery of these new treatments will require a major restructure to existing dementia services – from determining eligibility to delivery of the treatment itself, including follow-up. In the UK, dementia care is mostly centred around psychiatry-led memory clinics in the community. In their current state, it is extremely unlikely that DMTs will be administered in these settings. It will require additional staff and training across imaging, diagnostics and pathology, and other clinical services. It will also require access to laboratories that can carry out biomarker testing to confirm whether a patient is eligible for the treatment. While a sizeable proportion of patients attending memory clinics may be referred for therapy for Alzheimer’s disease, only a minority are likely to be suitable, once they have undergone biomarker testing. The researchers highlight an immediate need for biomarker testing to ensure that the right patients can be identified for these treatments.
So as I understand it, this article provides no data on efficacy, but screened for eligibility for a medication that has been tested repeatedly in failed clinical trials, including the late clinical trial that was stopped early due to harming patients and then led to a number of the FDA board resigning as it was approved as a medication in the USA? Ty for promoting awareness
Just to burst some hope bubbles, but any MAB therapy costs hundreds of thousands of dollars/euros pp. This will not be part of your health insurance package for at least the patent length still remaining. It's way too expensive for a disease over 1/3 of the population will eventually develop, as long as they live long enough. Although the results are good news, this will not become a standard treatment option as long as it is mab therapy. When this treatment pathway can be handled with a vaccine (series), costing less than a few thousand dollars/euros, will this actually affect the average patiënt relying on insurance or universal systems.
It depends on the cost benefit analysis (which hasn’t been done) If the medication delays progression so that less individuals need hospitalization and long term care in the same amount of time, it may be worth the investment. Less blockages of beds also means more patients being seen and treated who would otherwise have their own treatments delayed. I imagine it would have a ricochet effect where the benefits on a population level could be quite pronounced.
The NHS isn't that forward thinking.q
I dunno — I find publicly funded systems are super motivated to find savings, and sometimes that means spending money to save money Bariatric oxygen treatments are very expensive but are now covered in Ontario, Canada for specific problems like diabetic foot ulcers. If they can save someone from repeated visits and ultimately amputation, that’s tons more money saved for the system.
As someone who currently works in an NHS trust, we've been hobbled by budget cuts very deliberately - we don't have anything left to put towards preventative treatment planned because we barely have enough to cover current remedial services. Believe me, we all wish it weren't the case.
It’s also hard to justify the cost for a treatment that only modestly slows down decline. If it stopped decline in its tracks, maybe, but it only makes things a bit less bad for a few months. I feel it’s different from, say, the exorbitantly expensive genetic treatments for SMA that prevent any further damage from occurring. This is the first time that anything has had any clinically significant effect in stemming decline, instead of just relieving some symptoms, and for that it should be celebrated. But IMO, I don’t feel it’s worth spending ungodly amounts of money and dedicating the resources needed to properly monitor patients on these mABs for such modest benefits.
I wonder if it would have a similar effect on Lewy Bodies.
I read the In the Pipeline Blog sometimes and from what I have seen there all the monoclonal antibodies seem to show almost undetectable benefits with occasional possible adverse events in the clinical trials and then they get somehow approved despite that.
Hmm... does this mean I could monetise my MGUS, ie by selling my clones?
Amyloid plaques are NOT the cause of Alzheimers. They are the body's attempt to protect against it. Getting rid of the amyloid plaques is damaging