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, March 24, 2023

alzheimers news-it didnt work


amyloid begins to accumulate in the brain forming plaques years before symptoms start
the amyloid plaques causes brain cell destruction in the brain
tau proteins accumulate in the brain as tau tangles causing more brain cell death
the body sends in its inflammatory army which kills more brain cells

it was felt that if you could remove the amyloid from accumulating you could stop or slow down the alzheimers disease process in the brain

antiamyloid antibodies called monoclonal antibodies were developed

solanezumab was one of the first
later came my drug aduhelm or aducanumab and now we have leqembi or lecanemab
soon to be approved is the newest one donanemab

each one seems to work better than the previous one

solanezumab approached the amyloid plaques differently
as the final report shows it was not good enough
when i read the final report it didnt work better than placebo

lucky for us in the alzheimers world the newer ones do work in removing amyloid plaque and slowing memory decline

i recently read an old blog i wrote about 8 years ago about trying to get in the solanezumab studies

one study was treating folks with moderate alzheimers
i wasnt far enough along to qualify for that one
that study was not effective in slowing down the disease

the second study 
the a4 study
antiamyloid treatment in asymptomatic alzheimers

to get in this study

you had to have amyloid plaques in the brain
ie a positive amyloid pet scan or positive amyloid levels in the spinal fluid

you had to have normal memory on memory testing

that would mean you are prealzheimers or prodromal alzheimers

i tried to get into the study but was turned down even though my memory was back to normal on testing
it was those initial scores those first two years that kept me from being in that a4 study

as it turns out for me im glad i didnt get in the study since i later got into the aduhelm or aducanumab study that i am in now

in the a4 study solanezumab didnt work
amyloid pet scans showed no change in the amyloid pet scans in either the treated group or placebo
memory continued to decline in both groups

these three other ones i mentioned above do remove all the measurable amyloid from the brain
most within 12 months
these three other ones also show a slowing of memory decline
these three others ones are approved for use in early alzheimers and mci or will be soon

these three other ones are doing their own long term studies in folks who are prealzheimers
ie positive amyloid pet scans with normal memory 
i expect these three other ones to show that treating people before symptoms start will be successful

for me
when i was say 50 had i known then what i know now and this was available
i would had asked to be in these prealzheimers studies 
i would have been getting monthly infusions while in my last 10 years of practice
if it worked i would not have had to quit practicing medicine at 60
i would die at an old age but it wouldnt be from alzheimers

thats what we are looking at if these newer antiamyloid drugs work

i think about the folks who were in the a4 study
some got placebo some got the real drug
it didnt work
they had all hopes for over 5 years some a lot longer
to find out 
solanezumab just didnt work
at all

how devastating that must be

i remember how i felt after about 18 months our study was abruptly stopped
i felt like i had been kicked hard in stomach
im sure thats how the a4 study subjects felt

they lost ground on their disease that they will never get back

in medicine sometimes you have to have a lot of failures before you have success

next tuesday i get my #28 infusion of aduhelm or aducanumab at ucla
my amyloid pet scan is in about 6 weeks
it should read out clear of amyloid plaques
oh how i would love to see that scan

the organicgreen doctor

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