After a long period of repeated failure, the first drugs which are able to modify the disease course of dementia (specifically Alzheimer's disease) have been described. The development of these medicines, at the time of writing monoclonal antibodies to amyloid, have been controversial. Initial trials of similar drugs were disappointing before the first positive results emerged for aducanumab. Though this drug was licensed in the US, the data was not clear. Two further drugs, lecanemab and donanemab, have published more clearly positive results. Controversy has persisted both over the clinical meaning of any improvement, the benefit of risks and harms, costs and the size of the minority of people who might be eligible to take them. This controversy is reflected in differences in regulatory approvals. For example, lecanemab has been licensed of use in many places in the world, though not in Europe. It has been approved for use by the MHRA, but NICE have indicated it is unlikely to be available on the NHS due to concerns over cost effectiveness. This is a confusing landscape for clinicians and patients.
The field is changing rapidly, and no doubt will have changed prior to the Congress. New antibodies are in trials, as are new routes of administration of existing drugs (for example subcut rather than iv) and less frequently there is the possibility of blood tests replacing the need for lumbar puncture or PET imaging. New drugs which work through different putative mechanisms have been submitted for approval or are in late stage pivotal trials.
In this session we will summarise this history and the current situation. We will hear from clinicians and people with lived experience about the challenges and opportunities this presents and we will review the likely changes in the near future, leaving plenty of time for discussion.
Learning objectives
By attending this session you will:
- Understand recent developments in disease modifying drugs for dementia
- Understand the current national and international licensing and NICE position on these drugs
- Understand the perspective of clinicians and people with lived experience of dementia on these changes.
Speakers
Chair: Dr Mohan Bhat, Kent and Medway NHS and Social Care Partnership Trust, Maidstone
Dr Robert Barber, Cumbria, Northumberland, Tyne and Wear NHS Trust, Newcastle
Dr Chineze Ivenso, Aneurin Bevan University Health Board, Newport
Dr Ben Underwood, University of Cambridge, Cambridge
Availability
This webinar is part of the Congress webinar 2025 package. If you attended all four days of Congress, you will have access to these as part of your Congress package. Otherwise the Congress webinar 2025 package can be purchased below.
