A New Era in Alzheimer's Disease: Insights from Dr Emer MacSweeney

Alzheimer’s disease, a progressive neurodegenerative disorder, is at the forefront of groundbreaking research, as new treatments and diagnostic tools continue to emerge. During a recent Medical Education Talk hosted at Loveday Kensington, Dr Emer MacSweeney, consultant neuroradiologist and Medical Director at Re:Cognition Health delivered a presentation titled "Alzheimer’s Disease: A New Era – Diagnosis and Treatment." Dr MacSweeney spoke about the evolving landscape of Alzheimer's research, focusing on new-generation medications, clinical trials and the promising treatments that could change the future for millions of people globally.

The Growing Field of Alzheimer’s Treatments

Over the past few years, Alzheimer’s research has shifted gears, with one medication opening the doors to a wave of new drugs currently in development. Dr MacSweeney discussed why these drugs are being developed and tailored in specific ways to address different aspects of the disease, from amyloid plaques to tau protein tangles.

At the forefront of this innovation is Re:Cognition Health, which has six clinical trial sites dedicated to neurodegenerative diseases. Having conducted over 150 clinical trials and treated 6,000 patients, Re:Cognition Health represents a crucial piece of the puzzle in identifying the best treatment pathways for Alzheimer’s. In fact, 164 clinical trials are set to be in progress for Alzheimer’s by 2025, with 93 of them focusing on Disease Modifying Treatments (DMTs).

A Look at New and Emerging Medications

Several drugs are currently in the spotlight for Alzheimer’s treatment, with some already approved for use in the US. Dr MacSweeney shared updates on these medications and what they mean for the future of Alzheimer’s care.

• Aducanumab: Aducanumab made headlines as one of the first medications approved to slow the progression of Alzheimer’s by targeting amyloid plaques. However, despite its initial promise, the drug was discontinued as a new treatment. Aducanumab had been developed to clear amyloid proteins from the brain, but its challenges—including cost, side effects, and the emergence of more effective therapies—led to its limited adoption.
• Lecanemab (Leqembi): This next-generation amyloid-clearing drug has shown promising results, taking over where aducanumab left off. Lecanemab works by clearing amyloid plaques from the brain within 18-24 months, offering a more effective treatment option. However, it is not without risks, including the potential for ARIA (Amyloid-related imaging abnormalities)—specifically ARIA-E (brain swelling) and ARIA-H (haemorrhage). While Medicare in the US has approved lecanemab, covering 80% of the cost, patients can access this treatment privately through Re:Cognition Health centres in the UK, it is not available through the NHS, due to cost.
• Donanemab: Recently approved in the US, donanemab is seen as a trailblazer in Alzheimer’s research. Clinical trials, such as the Trailblazer study, have shown promising results, with many patients seeing complete amyloid clearance within 18 months. Like lecanemab, this drug will soon be available for patients to access privately in the UK, but it will not be available through the NHS.
• HMTM: Another exciting development is HMTM, an oral anti-tau drug that is also under review by the MHRA. This medication has shown the ability to slow disease progression while providing cognitive improvements, particularly in amyloid-positive patients.

Dr MacSweeney stressed the importance of patients seeking an accurate and early diagnosis. There are many new-generation medications currently available through clinical trials for people with early stage Alzheimer’s – the sooner treatment begins, the better the outcomes. 

The Future: Vaccines, Monoclonal Antibodies and Prevention

Looking forward, Alzheimer’s prevention strategies are gaining traction. One exciting area of research focuses on creating vaccines against tau proteins, which play a crucial role in the development of Alzheimer’s. Other innovative approaches include generating personalised monoclonal antibodies to protect against tau build-up.

A key development in diagnostics is the use of blood biomarkers, particularly pTau 217, which can indicate the early presence of Alzheimer’s. This biomarker could revolutionise early detection, allowing for interventions long before cognitive symptoms appear. Dr MacSweeney emphasised that unexplained anxiety in individuals in their early 60s could be an early warning sign, underscoring the importance of early diagnosis and action.

The Complex Nature of Alzheimer’s Disease

One of the key takeaways from Dr MacSweeney’s presentation was the understanding that Alzheimer’s is not a singular disease. It is caused by the collapse of systems crucial to brain cell function, and cognitive issues can arise for many different reasons. This is why Alzheimer’s cannot be pinpointed to one biomarker or treated with a one-size-fits-all approach.

As research continues, the goal is to develop personalised treatment plans that address the various factors contributing to Alzheimer’s. Early intervention remains essential, as it offers the best chance of slowing disease progression and improving quality of life for patients.

Living a Healthy Lifestyle to Reduce Risk

In addition to discussing clinical treatments, Dr MacSweeney highlighted the role of lifestyle factors in Alzheimer’s prevention. A healthy lifestyle can significantly reduce the risk of developing the disease. Key factors include:

• Avoiding smoking
• Managing diabetes and depression
• Staying socially engaged
• Prioritising sleep
• Keeping the brain mentally active
• Regular exercise
• Reducing alcohol consumption
• Minimising exposure to air pollution

These preventative measures, combined with emerging medical treatments, offer hope for a future where Alzheimer’s is more effectively managed or even prevented.

New Era for Alzheimer’s

Dr MacSweeney’s presentation at Loveday Kensington offered a glimpse into a new era for Alzheimer’s diagnosis and treatment. With innovative drugs like lecanemab and donanemab and HMTM on the horizon, with additional promising prevention strategies in development, the future looks brighter for those affected by this devastating disease.

For further information on opportunities in clinical trials,visit Re:Cognition Health.