Lecanemab, Donanemab, Lecanemab , Donanemab… they sound like magic spells.
Great joy when Lecanemab was approved for use in the UK. Great disappointment when it was not approved for use through the NHS. Was that fair to all those waiting for something that might deal with dementia?
The two ‘emab’ treatments are certainly a breakthrough. They show decisively that tackling amyloid proteins are an effective way forward. Researchers had begun to doubt that. But their biggest limitation – apart from worrying side effects and cost – is the need to take them very early in order to benefit.
That raises two questions:
- do we have the capacity to provide early diagnosis? The answer is clearly ‘No’: many are already waiting too long for diagnosis.
- even if we did, do we want to press people for early diagnosis, almost before any symptoms appear? Do we want everybody to ‘test for dementia’ as routine? Do we want to know, far in advance, what might happen to us?
The big challenge now – apart from continuing research in all areas – is to go on ‘treating’ those living with dementia and supporting those who care for them. That means serious commitment, from the government, from all of us, to ‘reimagine care and support’.
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