admits that it is not proven that the new drug, a monoclonal antibody to be sold under the name Aduhelm, actually works. The approval is misguided. It risks raising unrealistic expectations, wreaking financial harm on health-care systems, damaging the’s reputation for scientific impartiality and perhaps even diverting attention from more hopeful approaches to treating dementia.
An “amyloid hypothesis” holds that the protein is not just a symptom of the disease, but a prime cause. This is widely believed . But it is just a hypothesis . Thehas demanded a further trial, even as the drug goes into use, and has warned it may pull the drug if it is unsatisfactory. Biogen has said that the trial may take nine years. And if the drug is in wide use, withdrawing it would be difficult.
At $56,000 a year, the cost of Aduhelm treatment will create huge problems for health insurers and providers. Certainly the stockmarket has rewarded Biogen’s shares in the belief that a new blockbuster drug has just been given clearance. It is recommended only for people in the early stages of Alzheimer’s, diagnosed by a costlyscan, and will require a course of monthly intravenous administration at a medical facility. Patients will require close monitoring as many develop brain swellings.
That the evidence argued against the approval of Aduhelm does not mean that research into treatments for dementia is going badly. On the contrary, whereas a few years ago some pharmaceutical firms were withdrawing from the field, having written it off as a dead end, some neurologists now expect big breakthroughs. A better understanding is emerging of how the risk of developing dementia can be reduced, by living a healthier life.
Dementia remains one of the 21st century’s greatest health, social and economic problems, and, for some neurologists, anything that stimulates greater efforts to understanding and treating it is welcome. That is why even some of those who have been baffled by the scientific basis of theduhelm approval have applauded it. Surely, however, hope lies not in lowering standards out of desperation, but in following the science.
this is terrible news
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