New York City, September 2024 — In a world where memory flickers and fades, two new drugs—Leqembi and Kisunla—offer the tender promise of hope. But as the scientific community gathers its thoughts, there is both celebration and silence. Like a fragile leaf in autumn, these treatments drift between triumph and uncertainty, leaving behind a swirl of questions for the families who wait, hearts heavy, at the door of possibility.
The Promise of New Treatments
Developed by Biogen and Eisai, Leqembi holds the potential to slow the cruel unraveling of Alzheimer’s, while Kisunla, created by Eli Lilly, stands as a quiet warrior, targeting the disease with the antibody donanemab. These names may seem distant to some, but for those who have watched loved ones fade into the shadowy recesses of dementia, they are words charged with longing, hope, and fear.
“These medications mark a point of inflection,” says John Hardy, a biologist who has spent decades walking the intricate paths of Alzheimer’s research. His voice, steady but filled with years of struggle, reflects the complexity of the disease. But even as the scientific community takes cautious steps forward, other voices rise in concern. Rob Howard, a psychiatrist from University College London, cautions against false hopes, warning that these drugs may only offer a fleeting glimmer of relief, not the profound change some desperately seek.
A Glimmer of Hope or Just a Mirage?
Leqembi and Kisunla are said to slow cognitive decline by 30% in the early stages of Alzheimer’s, but beneath this statistic lies a somber truth. For some, the benefit is so small it seems almost invisible—a light too faint to guide them home. Rob Howard speaks of the “dangers of raising expectations too high,” for when hope collapses, it leaves behind a devastation worse than despair.
And yet, some cling to these drugs like lifelines thrown into the ocean of forgetfulness. If these treatments can gift a loved one even a few more moments of clarity—a chance to remember a name, a face, or a place once cherished—then perhaps they are worth the cost, both financial and emotional.
The Weight of the Price Tag
But these lifelines are not without cost. A study published in Lancet estimates that treating every eligible Alzheimer’s patient in the European Union with Leqembi could reach an astronomical €133 billion. It’s a number that looms large, especially for health systems already strained by other demands.
Governments across Europe weigh the price of hope, balancing it against the needs of millions. Meanwhile, in the United States, where both drugs have been approved, some families may find themselves grappling with impossible choices—do they spend their savings for a few more months of connection, of recognition in their loved one’s eyes, or do they accept the inevitable, allowing time to carry them forward without intervention?
The Shadow of the Past and Future
Behind these new treatments is a theory that has stood like an old tree in the scientific landscape—Hardy’s amyloid cascade theory, first proposed in 1992. The theory suggests that the build-up of amyloid plaques in the brain is the root cause of Alzheimer’s. And yet, as strong as this idea once seemed, it has faced fierce winds of criticism in recent years. Many now wonder if the focus on amyloid has led researchers down a path too narrow, overlooking other potential avenues for treatment.
Christian Guy-Coichard, an outspoken critic of the pharmaceutical industry’s close ties to scientific research, reminds us of the failures of the past. Biogen’s earlier attempt, Aduhelm, once heralded as a breakthrough, was pulled after controversy and backlash. It stands as a stark reminder that sometimes the roads we think will lead to salvation instead circle back on themselves.
Yet John Hardy, resilient and steadfast, believes that Europe’s rejection of Leqembi is a mistake—one that could deepen the divide between those who can afford access to treatment in the United States and those who cannot. “We risk creating a world where the wealthy have hope, while the poor are left to fade.”
Looking Beyond the Horizon
As families, doctors, and governments weigh the potential of these drugs, there is a growing recognition that the fight against Alzheimer’s is far from over. New treatments may offer a sliver of time, a gentle slowing of the tide, but they are not a cure.
The medical community must continue its pursuit of other paths, seeking out treatments that address more than just the symptoms. Alzheimer’s, with all its heartache and complexity, deserves nothing less than our full, unrelenting effort to find a cure that not only halts its progress but brings memory back to those lost in its fog.
For now, though, we stand at the edge of uncertainty, balancing hope and heartbreak, waiting to see if these drugs can truly offer the gifts they promise. As the community debates, and families make impossible choices, the clock ticks forward—steady and sure, like time itself, unforgiving yet full of possibility.
