Lequembi

Gthoma

If this is the "first drug to slow the progression" why is my PWD taking aricept and namenda? Our neurologist told us this combination would slow the progression when she started it 2 years ago.

And why am I not seeing any comparison of any of the new drugs to aricept and namenda?

Crushed

Because there is a difference between the disease and the symptoms

We cant sure colds but we can make the symptoms less annoying.

aricept and namenda treat symptoms

Elshack

Maybe it is a matter of semantics but if Namenda treats symptoms would that manifest itself as slowing the progression? My DH began taking Namenda 6 yrs ago and it really seemed to help his memory etc. from getting worse. Sadly he fell over 4 yrs ago and had several subdural hematomas ( brain bleeds ) and had to have brain surgery and that of course put him into the moderate dementia category. Now he is nearing stage 7 and in memory care and on hospice ( he is 93 ) but I have to say I was glad he had been on Namenda for the few years before his surgery. Our neurologist was a big believer in Namenda.

ImMaggieMae

Memantine, the generic version of Namenda seems to very helpful to my husband as well. At 10mg per day I couldn’t see a difference, but at 20mg it made quite a difference.

Quilting brings calm

https://alzconnected.org/discussion/65572/lequembi

This new drug wasn’t available two years ago for her to take. It just got approved this week, so it’s not really available even now.

The earlier drugs mask the symptoms and allow the person to function better for a while / but the progression is still happening inside the brain at whatever pace it’s happening at. Supposedly the hew drugs slow the progression. However the new drugs cones with more serious side affects including a brain bleed for sone people that can hasten the progression. I’m not willing to see that happen on my loved one.

Ed1937

"However the new drugs cones with more serious side affects including a brain bleed for sone people that can hasten the progression. I’m not willing to see that happen on my loved one."

The last I saw on that topic was that only a small number of people with brain bleeds will even know it because they are so small. But it remains a personal choice, and I don't think there is a right or wrong way to make that decision. Maybe with time we'll have a better answer as to how much it can help, and a better understanding of the pros and cons. Let's hope for the best.

Crushed

https://alzconnected.org/discussion/comment/176456#Comment_176456

You have a bone cancer and take painkillers Pain is a symptom. Relieving the pain does not affect ther progression of the disease

What is the medication Namenda used for?

Memantine reduces the actions of chemicals in the brain that may contribute to the symptoms of Alzheimer's disease. Memantine is used to treat moderate to severe dementia of the Alzheimer's type

Lane Simonian

Aricept and Namenda effect a part of the disease process, but only slow down the progression of the disease for awhile. Aricept for example becomes no better than placebo after one year.

The argument being made on behalf of Leqembi is that by removing amyloid it is addressing the central cause of the disease and thus is modifying the course of the disease. There are several problems with this argument. Most importantly, amyloid is not the main cause of Alzheimer's disease. About 35% of non-ApoE4 carriers have little to no amyloid in their brain, and Leqembi has not effect on this population.

https://alzheon.com/pipeline/alz-801-development/

By removing amyloid from ApoE4 carriers, Leqembi is removing one cause of the disease (albeit a secondary one). The other causes that may have initially triggered the disease (high blood sugar, high blood pressure due to high sodium levels, stress, exposure to environmental toxins, etc.) remain. Leqembi does not address any of these other triggers and thus is not disease modifying.

In ApoE4 carriers, Leqembi slows down the progression of the disease by about .6 points (as measured by CDR-SB scores) over 18 months. For Aricept it is about the same (although Aricept is more effective in non-carriers and perhaps a little less effective in carriers than Leqembi). The FDA is defining a clinically significant change in early stage Alzheimer's patients at 18 months as .5 points, but others put this threshold much higher.

Since ApoE4 carriers progress more rapidly in Alzheimer's disease what Leqembi is doing is slowing their progression closer to the rate of non-carriers. But because it is pulling amyloid out of blood vessels as well as around neurons, it can cause brain swelling and brain bleeds that can be fatal.

Using Leqembi and Aricept concurrently may further slow done the disease for awhile, but perhaps not in a clinically significant way.

In the larger picture, Leqembi does not mark a great advance over existing treatments for Alzheimer's disease. It really does not mark an advance at all.