African Americans less likely to benefit from Leqembi

Lane Simonian

African Americans and perhaps other ethnic minorities appear less likely to benefit from Leqembi than whites:

"Although older Black Americans have twice the rate of dementia as whites, they were screened out of clinical trials of these drugs at a higher rate, according to interviews with 10 researchers as well as 4 Eisai and Lilly executives.Prospective Black volunteers with early disease symptoms did not have enough amyloid in their brain to qualify for the trials, the 10 researchers explained.Hispanics, who experience dementia at one and a half times the rate of whites, were also excluded at a somewhat higher rate due to low amyloid, though the issue was not as pronounced as for Black people, five of the researchers said."www.reuters.com/...

And here is where many in the Alzheimer's field have gone astray, they insist if you don't have amyloid, you don't have Alzheimer's disease. But amyloid only reaches levels that it contributes to Alzheimer's disease in certain populations. Those populations who have Alzheimer's disease, but low levels of amyloid don't benefit from Leqembi.

Why do African Americans (and perhaps other ethnic minorities) have higher rates of dementia but less amyloid. It took me a long time to try to find an answer to this question, but this appears to be the answer: African Americans have higher levels of oxidative stress, but lower levels of DNA oxidative stress.

aacrjournals.org/...

Higher levels of oxidative stress explain why African Americans are more prone to Alzheimer's disease. On the other hand, the enzyme that leads to oxidative damage to DNA also contributes to the formation of amyloid. What seems like a conundrum is not: greater risk of Alzheimer's disease for African Americans, but less amyloid.

Iris L.

I read the same thing in my local newspaper. Thanks for posting, Lane.

Iris