Perspectives on the clinical use of anti-amyloid therapy for the treatment of Alzheimer's disease: Insights from the fields of cancer, rheumatology, and neurology.

Introduction: The advent of disease-modifying therapies for Alzheimer's disease (AD) has raised many questions and debates in the field as to the clinical benefits, risks, and costs of such therapies. The controversies have resulted in the perception that many clinicians are apprehensive about prescribing these medications to their patient populations. There also remains widespread uncertainty as to the economic impact, cost benefit ratio, and safety oversight for use of these medications in standard clinical care settings.
Methods: To contextualize such issues, the present study compared anti-amyloid biologic therapy (lecanemab) to four commonly used biologic agents in other fields, including trastuzumab for breast cancer, bevacizumab for lung cancer, etanercept for rheumatoid arthritis, and ocrelizumab for multiple sclerosis.
Results: The data presented demonstrate comparable costs, clinical benefits, and risks for these biologic agents in their disparate disease states.
Discussion: These results provide context for the costs, clinical benefits, and safety regarding the mainstream use of anti-amyloid biologic agents for the prevention of cognitive loss. While the era of disease-modifying therapies for AD is now in its infancy, there is an expectation that these discoveries will be followed by improved therapies and combination treatments leading to greater efficacy in ameliorating the clinical trajectory of AD.
Highlights: Anti-amyloid therapy costs are comparable to other commonly used biologics.Anti-amyloid therapy efficacy is comparable to other commonly used biologics.Anti-amyloid therapy safety is compatible with other commonly used biologics.
Competing Interests: G.A. Jicha receives funding support from the National Institutes of Health, serves as a site investigator for ongoing clinical trials sponsored by AbbVie, Cassava, Cognition Therapeutics, Eisai, Eli Lilly, and Vivoryon, and has had travel funded by the Alzheimer's Association to participate in expert panel discussions. E.L. Abner receives funding support from the National Institutes of Health, has had travel funded by Ohio State University, and serves on a committee for the Alzheimer's Association. E.P. Coskun receives funding support from the National Institutes of Health and engages in contract research for ongoing clinical trials sponsored by Cognition Therapeutics, and Eisai. P.T. Nelson receives funding support from the National Institutes of Health. M.J. Huffmyer and T.C. Tucker have nothing to disclose. Author disclosures are available in the supporting information.
(© 2024 The Author(s). Alzheimer's & Dementia: Translational Research & Clinical Interventions published by Wiley Periodicals LLC on behalf of Alzheimer's Association.)