welcome to the organic green doctor blog

i am a family physician who was diagnosed with
early mild cognitive impairment(mci) amnestic type on december 21, 2010
this is a precursor to alzheimers disease
because of this diagnosis i have opted to stop practicing medicine
this blog will be about my journey with this disease
please feel free to follow me along this path
i will continue blogging on organic gardening, green living,
solar power, rainwater collection, and healthy living
i will blog on these plus other things noted to be interesting

Friday, May 27, 2022

alzheimers news-lecanemab vs donanemab as the next one to treat alzheimers


as a review
in the theory of alzheimers disease
amyloid begins to build up in the brain for some reason and form plaques
these plaques kill brain cells

tau proteins inside the brain cells began to unwind and form tau tangles
these tau tangles get outside the cells and kill brain cells

all this brain cell death causes the bodys inflammation army to move in to try to repair the damage
causing inflammatory reaction damage to the brain

for a true treatment 
you need to attack all three processes thats going on 

my drug aduhelm or aducanumab goes in and removes the amyloid plaques from the brain
the amount of amyloid can be measured by doing an amyloid pet scan
in the aducanumab study after a year of treatment most of the measurable amyloid plaque is removed

it also seems to lower the tau tangle levels

it also seems to lower the inflammation in the brain

there is about a 20% reduction in memory loss after that year

aduhelm attacks the amyloid protein and removes it

enter lecanemab and donanemab

they both act similar but different from aduhelm by attaching to a different part of amyloid
they both seem to do a better job of doing it
they seem to have less side effects
they both also in phase 2 studies seem to work better than my drug biogen aduhelm

the fda approved aduhelm or aducanumab for use in mci due to alzheimers and in mild alzheimers
cms the ruler of medicare and medicaid only approved paying for it in clinical studies

the result is its not being used much in the private world since no one will pay for it
most of it is being used in clinical trials

aduhelm will be starting an at least 5 year study required by the fda before it will reconsider its ruling
my study i am in is called embark 
it will be finished in about 1-2 years then we will know better after that how well it works

now the other two will be where aduhelm will be in two years this fall

both will probably apply for full coverage and full approval
they both likely will get it if their results are promising

biogen in marketing aduhelm or aducanumab tried to circumvent the system and get it approved too early 

they are now paying the price 
no cms approval for payment and little use of it since people in the private world have to pay out of pocket

lecanemab is a biogen and eisai drug
eisai is now running the show since biogen screwed up with the aduhelm marketing 

donanemab is an eli lilly drug

gantenrumab is a roche drug that is not far behind these two

the end result may be 
donanemab and lecanemab might have full approval by the fda the first of 2023
they both will be available for use
if they get full approval cms will most likely cover them in the private world

in a year from now
these two drugs will be available if all goes right for those in the alzheimers world to start using and get it paid for

i do worry though that alzheimers disease is the stepchild of the cms world and there may be attempts to limit these drugs use to save money for a disease that is only mainly killing old people
an expendable group of people when it comes to money
just watch what they try to do with social security and medicare

you can get a feel for what could happen when you look at what happened to all those elderly folks in long term facilities in regards to covid 19 care and treatment
they were expendable

dont let them expendable us

the organicgreen doctor

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