New drugs that could potentially alter the progression of Alzheimer’s disease are anticipated to be given approval in the UK by the middle of the year. New research suggests that healthcare systems may need to adapt to guarantee that all patients have fair access to these new anti-amyloid therapies that can modify the disease. This research was led by Queen Mary University of London and University.The University College London (UCL) reports that Alzheimer’s disease is the most common cause of dementia in the UK, affecting 60-80% of the 944,000 people living with dementia. While current drugs only address symptoms, new therapies using monoclonal antibodies to remove amyloid plaques on the brain have shown promise in slowing disease progression. These ‘disease-modifying therapies’ (DMTs) have received ‘breakthrough therapy’ designation in the UK and are expected to be available to patients by mid-2024, pending regulatory approval.In the UK, dementia care is mainly focused on memory clinics led by psychiatrists in the community. It is highly unlikely that DMTs will be given in these settings in their current state. Implementing these new treatments will necessitate a significant redesign of existing dementia services, encompassing the determination of eligibility and the administration of treatment, as well as follow-up. This will require more staff and training in imaging, diagnostics, pathology, and other clinical services. It will also necessitate access to labs capable of conducting biomarker testing to confirm a patient’s eligibility for the treatment.The possible introduction of DMTs poses significant difficulties for healthcare services and could worsen existing disparities in service access. To address and reduce these difficulties, a team of researchers from Queen Mary’s Centre for Preventive Neurology, UCL’s Dementia Research Centre, and UCL Partners conducted important research to estimate the number of patients who may qualify for DMTs.
The researchers analyzed clinical case notes from more than 1,000 individuals who visited community memory clinics or specialized cognitive services in England. They discovered that 32% of those who visited memory services and 14% of individuals attending specialized cognitive services were eligible for DMTs.cognitive services would likely be considered for the new DMTs. The study discovered that amyloid biomarker tests, such as PET scans and spinal fluid tests, were available for individuals visiting specialized cognitive services. However, less than 1% of attendees at community memory clinics had undergone biomarker tests.
Although a significant number of patients at memory clinics may be recommended for Alzheimer’s disease therapy, only a small percentage are expected to be eligible after undergoing biomarker testing. The researchers emphasize the urgent necessity for biomarker testing to guarantee the suitability of the individuals for new DMTs.The goal is to identify the appropriate patients for these treatments. According to Professor Ruth Dobson, who is a Neurology Professor at Queen Mary University of London and a Consultant Neurologist at UCL Partners, the development of disease-modifying therapies for dementia could lead to significant changes in healthcare services. She emphasizes the importance of proactively understanding and planning for these changes in order to ensure the best care for all dementia patients, regardless of initial treatment availability and eligibility. Professor Rimona Weil leads the study.Neurologist at UCL and the National Hospital for Neurology and Neurosurgery, and Dementia Theme Co-Lead for UCL Partners emphasized the importance of working with clinicians who run memory clinics to gather real-world estimates on the number of people likely to be referred for new drugs. Study co-lead, Professor Catherine Mummery, Consultant Neurologist at UCL and the National Hospital for Neurology and Neurosurgery, highlighted the impact of diagnostic resources on diagnosis accuracy and referral patterns, emphasizing the need for a collaborative network.”Approach is crucial for establishing an effective treatment service in preparation for these upcoming therapies.” David Thomas, the Head of Policy and Public Affairs at Alzheimer’s Research UK, emphasized the importance of accurate and early diagnosis for people with dementia symptoms to fully benefit from new Alzheimer’s drugs. Thomas also highlighted the current inadequacy of the NHS in providing routine testing and urged the next government to invest in the NHS promptly.The appropriate diagnostics and workforce are crucial for identifying individuals who could potentially benefit from new treatments if they are approved by regulators. A vital component of the solution involves more affordable and widely accessible diagnostic tools, like blood tests, for use in clinical settings.”
Researchers from the Academic Health Science Centre for UCLPartners and a network of clinicians in memory clinics in London and the South East collaborated on this study.
