Scientists already know that patients getting any amyloid-targeted therapy need repeat brain scans to check for those side effects - a costly and time-consuming hurdle. About a quarter of donanemab recipients showed evidence of that swelling, and about 20% had microbleeds.

The main safety concern is brain swelling or bleeding, which often causes no symptoms but sometimes can be serious, even fatal. How much difference does that make? It means donanemab slowed patients’ worsening by about four to seven months, the JAMA report concluded.Īnother way of measuring: Among the donanemab recipients with lower tau levels, 47% were considered stable a year into the study compared with 29% of those who got the dummy version. Some patients fared better - those with low to medium tau levels saw a 35% slower decline, reflecting that the drug appears to work better in earlier stages of the disease. The results: Both groups declined during the 18-month study but overall those given donanemab worsened about 22% more slowly. And because amyloid alone doesn’t cause Alzheimer’s, researchers also tracked levels of another culprit in the brain - abnormal tau. Patients were switched to dummy infusions if enough amyloid cleared out - something that happened to about half within a year. Half received once-a-month infusions of donanemab and half dummy infusions for 18 months. Lilly’s study enrolled people ages 60 to 85 who were in early stages of Alzheimer’s. Eric Widera of the University of California, San Francisco, wrote in a JAMA editorial accompanying Lilly’s new data. “The modest benefits would likely not be questioned by patients, clinicians or payers if amyloid antibodies were low risk, inexpensive and simple to administer. Scientists say while these drugs may mark a new era in Alzheimer’s therapy, huge questions remain about which patients should try them and how much benefit they’ll really notice.

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