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

Monday, June 17, 2024

alzheimers news-here comes another one


there will soon be three drugs that will remove amyloid plaque from the brains of alzheimers patients 
doing this may slow down cognitive loss by about 30%
will removing this plaque make a difference

follow me over the next 10 years
if i am still doing this blog in 2034 then you know that removing amyloid plaque will have made a difference

in the theory of what happens with alzheimers
amyloid plaques accumulates first and kills brain cells
tau proteins in brain cells unravel forming tau tangles and kills brain cells
inflammation in the brain occurs as the body attacks this brain cell destruction and kills more brain cells

this is what happens in alzheimers

we now can remove amyloid plaque with three new antiamyloid monoclonal antibodies that bind to the plaques and removes them

the first drug to get approved was my drug aduhelm or aducanumab
i took 34 months of infusions which has removed all the measurable plaques in my brain as shown on an amyloid pet scan done last winter
will it make a difference
time will tell

aduhelm made by biogen and eisai was recently taken off the market since its sister drug leqembi works better and may have fewer side effects

the second drug is leqembi or lecanemab made by biogen and eisai which removes the amyloid plaques also but quicker than aduhelm and maybe will less side effects
its given as an every 2 weeks infusions
it may only need to be given for 12-18 months
its approved by the fda and medicare pays for it and the accompanying scans required ie amyloid pet scans and mri scans
its also will be soon probably approved to be given just once a month and maybe given as an injection at home

the third drug is donanemab which removes the plaques quicker than the other two but maybe with more side effects
it may be used only less than a year
this drug made by lilly just got fda pre approval and will receive full approval soon

the major side effect of these drugs are brain bleeds or aria or amyloid related imaging abnormalities
these aria can be just edema or they can be bleeds
it is more likely to happen in those with the homozygous apoe4 apoe4 gene
called the late onset alzheimers gene
that one  i have
i didnt have aria ie edema or bleed
i did develop ocular migraines manifesting as visual changes headache nausea 
the headaches would last for several days
the visual changes for up to an hour
these were strong at first but gradually become less intense
the drug was stopped for a couple of months until serial mris of the brain were normal
these headaches are resolved now that i am off the drug

so the biggest risk is these brain bleeds 
most that occurred resolved and didnt prevent folks from continuing treatment
there were a few deaths though from these bleeds

when i signed up for the aduhelm clinical trial the risks were spelled out on the consent forms
pages of paper work were signed it seemed every year i was on the study

i decided i was willing to take the chance since the potential outcome of a potential new treatment for alzheimers was significant
time will tell if it worked

probably most folks in the studies felt the same

would i take one of these drugs now if i was early in the disease
i would maximize my health
i would take aricept of donepezil to slow down symptoms
i would seek treatment with either leqembi or the new one donanemab
probably leqembi especially if it goes injectable at home and just once a month
i would watch closely the new clinical trials with new drugs to treat tau tangles and inflammation
i would watch closely the research on when the amyloid reaccumulation would need to be treated
right now it may require periodic treatments with leqembi or donanemab 
hopefully something that can be done at home

we are entering a new era of alzheimers treatment
we are just at the beginning 
sort of like they were with heart disease by treating cholesterol long before it caused problems
now we will be treating amyloid plaques and tau and inflammation long before alzheimers starts
maybe like with heart disease we can prevent the disease alzheimers from developing

i think thats the goal

for me
i am getting in on part of all this but probably will miss all the treatments coming down the pike
if my disease doesn't progress too fast or far i may make it to these newer future treatments

the organicgreen doctor

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