toskanews) – One new frontier in the treatment of Alzheimer’s it is already a reality in Europe, but in Italy there is still a knot to untie: the refundability. In fact, in many European countries new monoclonal antibodies are already available which allow slow the progression of the disease in the initial stages, intervening directly on the mechanisms underlying cognitive decline. Medicines which, precisely for this reason, have received the green light from the European Medicines Agency. In our country, however, the final decision lies with the Italian Medicines Agency.
Monoclonal antibodies against Alzheimer’s
«We are talking about two drugs, two monoclonal antibodies – lecanemab and donanemab – which in fact constitute the first two therapies that in a clinical study have shown slow down the clinical course of Alzheimer’s disease – explains Lorenzo Gaetani, neurologist at the Perugia hospital to askanews -. Therefore, having these treatments available would mean for a clinician having for the first time the possibility of offering a therapy that can modify the course of Alzheimer’s disease. And all this would obviously have positive effects not only for the person suffering from Alzheimer’s disease, but also for his entire family context and the loved ones close to him. So undoubtedly having these therapies available would represent for the first time having in our hands a tool that can change the course. It means that the disease will not stop, the disease will not improve. But in fact it will progress more slowly than it would have done without the possibility of using these therapies.”
The decisive role of early diagnosis
A key role is also played by diagnosis. Nuclear medicine becomes crucial in early identifying the patients most suitable for this type of therapy and minimizing the risk of side effects.
«Access to therapies is fundamental for patients and their families, and nuclear medicine plays a helping role here. He played it at the time of clinical trials, because it is one of the reasons that allowed the development of therapies, because PET with amyloid tracer highlights precisely the target against which these therapies act – Silvia Morbelli, professor of Nuclear Medicine at the University of Turin, tells us -. Today it is important to treat these patients, and to do so at an early stage: nuclear medicine, always with PET tracer for amyloid, provides information at an early stage when the patient is demonstrating the first symptoms and has been confirmed by an accurate clinical neuropsychological evaluation. And it also has a fundamental role, at least in one of these drugs, in identifying the patient who has biologically responded and can stop therapy. If patients stop therapy early thanks to the information that comes from the PET, they can obviously leave the MRI check for safety. And also for families, clearly the commitment to managing this moment of therapy becomes shorter, because clearly we need to think about the patients, but always also about the caregivers.”
The comparison in Italy
After the rumors about a possible negative opinion from AIFA, a discussion was opened with experts and patient associations on a decision destined to have a not only clinical, but also social and economic impact.
«It would be a great therapeutic opportunity, a great possibility of finally being able to do something to modify this disease – underlines the neurologist Gaetani -. But at the same time, also a big effort to try to carefully select the people who can respond best and with the lowest risk of side effects.”
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