New Alzheimer’s Drug Accelerates Rate Of Brain Shrinkage By 20%

New Alzheimer’s Drug Accelerates Rate Of Brain Shrinkage By 20%. Hello everyone, I hope you are well. In today’s post, I will be sharing a press release from Food for the Brain Foundation. Founder Patrick Holford has responded to recent headlines about the new Alzheimer’s drug. Despite the promising headlines claiming a breakthrough in Alzheimer’s treatment, a closer examination of the study’s details has revealed alarming findings. The drug treatment has been shown to accelerate brain shrinkage by over 20%, raising significant concerns about its overall efficacy and safety.

New Alzheimer’s Drug Accelerates Rate Of Brain Shrinkage By 20%

Don’t be fooled by the rhetoric promoting the new Alzheimer’s anti-amyloid drug. The results – increased brain shrinkage, a third getting brain bleeding or swelling and no clinically meaningful benefit – are not good. However, reading this week’s headlines claiming a ‘turning point’ in the fight against Alzheimer’s, you’d be mistaken in thinking something new has occurred since Eli Lilly’s press release regarding their new drug, donanemab, a month ago.

This week’s front pages stimulated the publication of the actual study in the Journal of the American Medical Association [1], giving more details of the results. This was reported positively in every major newspaper. Yet not one reported that the drug treatment accelerated the rate of brain shrinkage by over 20% compared to placebo. The paper states, “At 76 weeks, MRI [scans] showed a greater decrease in whole brain volume”.

This is consistent with a meta-analysis of all anti-amyloid treatments, including donanemab, in the journal Neurology [2] earlier this year, which concluded that “Mild cognitively impaired participants treated with anti-amyloid drugs were projected to have a material regression toward brain volumes typical of Alzheimer dementia approximately eight months earlier than if they were untreated.”

In contrast, in treatment with homocysteine-lowering B vitamins, given to those with sufficient omega-3, ‘the rate of atrophy was significantly slowed by circa 70%’.[3] B vitamins and omega-3 are only two of eight established prevention steps you can take yourself.

Hippocampus

Alzheimer’s is characterised by brain shrinkage, particularly in the ‘hippocampus’, part of the medial temporal lobe at the brain’s centre. The new drug treatment was not associated with accelerated hippocampus shrinkage, just the whole brain. There was a minimal reduction, of about one per cent, in the shrinkage rate in this area of the brain compared to the placebo. The B vitamin study showed an 80% reduction in shrinkage in the medial temporal lobe. While it is theoretically possible that, having selected people with lots of plaques. Targeting them with an aggressive drug, the brain may shrink as part of the process of amyloid destruction. This is not yet known; therefore, this increased brain shrinkage is worrying.

Clinical Dementia Rating

The other primary measure of Alzheimer’s and dementia, made by a health professional, is the Clinical Dementia Rating (CDR). This includes interviewing the patient’s carer or partner and thus is potentially subject to ‘hopeful’ bias.

The other primary measure of Alzheimer’s and dementia, made by a health professional, is the Clinical Dementia Rating (CDR). This includes interviewing the patient’s carer or partner and thus is potentially subject to ‘hopeful’ bias.

The new drug treatment results show a statistically significant improvement, showing just over half a point  (0.67) less worsening, compared to placebo, on the 18-point CDR scale. But is this small change meaningful? A study in the Lancet suggests that minimum changes of 0.98 in mild cognitive impairment and 1.63 in mild Alzheimer’s disease are meaningful. [4] This study was on those with early Alzheimer’s.

In contrast, a trial giving omega-3 fish oils to those with adequate B vitamin status showed more than double this beneficial clinical effect [5]. In another, giving homocysteine-lowering B vitamins to those with adequate omega-3, almost two-thirds of the trial participants ended the trial with an overall Clinical Dementia Rating of zero [6]. This means they were no longer diagnostically labelled as having cognitive impairment. In other words, not less worse, but better.

Adverse severe Effects, Including Deaths

The recent donanemab paper gave more details on the adverse effects and trial deaths. ‘Treatment-emergent adverse events’ were reported by 759 of 853 participants (89%) receiving donanemab’ and ‘Either amyloid-related imaging abnormalities of edema/effusion [swelling] or micro haemorrhages [bleeding] occurred in 314 participants (37%) receiving donanemab’.

Also, in the donanemab group, ‘3 participants with serious amyloid-related imaging abnormalities subsequently died.’ Over a third had brain bleeding or swelling, and 1 in 287 died. This compares to no adverse events in the B vitamin and omega-3 trials or other prevention approaches. If any nutritional supplement had anything like these adverse effects, it would be banned, not licenced.

According to the Financial Times, this new treatment will cost $26,000 a year (in addition to medical costs, including numerous scans). In the UK, this would be paid by the taxpayer. In contrast, taking homocysteine-lowering B vitamins, eating fish and/or having fish oil supplements would cost perhaps 20p or cents a day – less than £100 a year.

Treatment

So, the question is, would you instead take a treatment that markedly slows both whole brain and medial temporal lobe shrinkage rather than a treatment associated with a more significant loss of brain volume, a high risk of adverse effects and high costs?

The big push is to get approval from the UK’s NICE  (National Institute for Health & Care Excellence) and the drug licensed in Europe. NICE has previously refused to consider the evidence for homocysteine-lowering B vitamins and omega-3, which is now overwhelmingly positive when both these nutrients are combined.

That is why we at Food for the Brain aim to make sure as many people as possible know that the real ‘turning point’ for Alzheimer’s is prevention through diet, nutrition and lifestyle improvements, not expensive drugs with dangerous side effects. You can take the free Cognitive Function Test yourself at www.foodforthebrain.org, and we encourage everyone to do so and take control of their brain health for the future.

I hope you enjoyed that

Talk soon

About FoodForTheBrain.org

The Food for the Brain Foundation is a UK-based charitable foundation that developed a fully validated Cognitive Function Test in 2012 and has so far tested 380,000 people. The test is available at www.foodforthebrain.org

REFERENCES

1. Simms J., et al JAMA July 17, 2023.
2. Alves, F., et al Neurology 2023 May 16;100(20):e2114-e2124.
3. Jernerén F., et al. Am J Clin Nutr. 2015 Jul;102(1):215-21.
4. Liu KY., et al Lancet Psychiatry 2021;8:-6.
5. Jernerén F., et al J Alzheimers Dis. 2019;69(1):189-197. doi: 10.3233/JAD-181148. PMID: 30958356
6. de Jager C et al Int. J. Geriatr. Psychiatry 27:592–600 2012