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 17, 2023

alzheimers news-they will cover its use in alzheimers


alzheimers patients accumulate amyloid plaques in the brain that damages brain cells
later tau protein tangles are released to kill more brain cells
then the body releases an inflammatory attack on all the damaged cells
all three of these things causes the damage seen in alzheimers disease

the hope is that by removing the amyloid plaques that this will slow down the disease process

enter the antiamyloid monoclonal antibodies

the first major one was solanezemab that didnt work
next came my drug aduhelm or aducanumab
it binds to amyloid plaques and removes them so that measurable plaques are gone after treatment 
i will have an amyloid pet scan in 2 months
this scan should have very little measurable amyloid that shows up on the scan
of course i wont ever get to see this scan or know its results

my study called the embark study will be reported out in about 1-2 years
it will probably show that it works
it probably wont work as well as the next one called leqembi or lecanemab

it will lower memory decline by about 22%
leqembi lowers memory decline by about 27%

biogen tried to rush approval for aduhelm or aducanumab
before the studies were finished
however the fda approved its use but medicare medicaid or cms did not agree to pay for it

esai and biogen handled both drugs
leqembi or lecanemab finished its studies and got approval by the fda
it works similar but different than aduhelm or aducanumab
it appears to work better 
it has to be given twice a month
it will cost less than aduhelm or aducanumab

my guess is that even though they both work 
doctors will give leqembi since it works better costs less has less side effects and doesnt have the stigma that aduhelm or aducanumab has 

leqembi is approved by the fda
medicare medicaid or cms has not agreed to pay for it yet
that decision will be in july of this year
there is a lot of pressure from advocacy groups to have them pay for it
the big one is the alzheimers association

now enter the va
they have around 160,000+ patients with alzheimers disease
some of them are early in the disease process
the va has agreed to treat their patients with mild alzheimers with leqembi

patients have to meet the criteria that one has to meet for clinical trials
here is a link to the criteria for a study similar to mine

the patients will be monitored closely
the va has a better system to monitor these than in the private world

if i was a veteran and was a va patient i would definitely qualify for this treatment
i have several relatives who are veterans who if they needed treatment could access it

it seems the va cost for this drug will be much less than the expected yearly cost of $25,000 a year expected in the private world

compare this to the the yearly cost of humira for rheumatoid arthritis of around $70,000
leqembi seems like a bargain to me

i think of these drugs as chemotherapy for alzheimers disease
were we talking about treating cancer or rheumatoid arthritis the feds would pay for this treatment

for me
in over 2 years from now i will have had close to 40+ monthly infusions of aduhelm
my results will probably be the same as what they would be if i was on leqembi
i will have to make a decision as to which treatment i want to do

it may be that if all the measurable amyloid is gone on the amyloid pet scan that i will go off the infusions and restart them only when the amyloid starts to reaccumulate again
there is talk of doing a maintenance dose every 3 months or so to keep the level down of amyloid 

by the time i finish my study they should know which way to go

will i do another clinical trial with a  new drug 
no i probably will not
i dont want to be in the control group again
i did my duty 
i did 5 years of the adni 2 study from 2010 to 2015
i did 18 months of placebo infusions in the beginning of the aduhelm studies
ive done my duty 
i want to be rewarded

if you are a veteran or have a veteran relative or acquaintance and they have the early symptoms of alzheimers you should consider seeking treatment with leqembi

there are no other options for now to slow the disease down

the organicgreen doctor

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