Why new Alzheimer’s drug works better for White than Black Americans? Alzheimer’s scientists told Reuters on Monday that new treatments for Alzheimer’s disease, which aim to remove the deadly substance beta-amyloid from the brain, may help White Americans more than Black Americans.
These therapies, Leqembi (produced by Eisai and Biogen) and donanemab (created by Eli Lilly), represent the first serious prospect of slowing the advancement of the fatal illness for the 6.5 million Americans living with Alzheimer’s.
However, interviews with 10 researchers and four executives from Eisai and Lilly revealed that older Black Americans, who have double the risk of dementia as whites, were excluded at a higher rate from clinical studies of these medications.
Why new Alzheimer’s drug works better for White than Black Americans?
This exclusion was due to the fact that prospective Black volunteers with early illness signs did not have enough amyloid in their brains to match the study standards.
Similarly, Hispanics, who had dementia at 1.5 times the rate of whites, were removed at a slightly greater rate due to low amyloid levels, albeit the problem was not as severe as it was for Black people, according to five researchers.
The accumulating evidence of this discrepancy in amyloid, a distinguishing feature of Alzheimer’s, has raised concerns among some scientists about who will genuinely benefit from the two new treatments, which the researchers claim are the first to be demonstrated to decrease the rate of cognitive deterioration.
Dr. Crystal Glover, a social psychologist and expert in equity in ageing research who directs clinical trial enrollment at the Rush Alzheimer’s Disease Research Centre in Chicago, questioned Leqembi, asking, “Is this even applicable to the groups that are most at risk?”
Around 20% of older Black adults are expected to have Alzheimer’s or similar dementia, which is double the prevalence of Whites and higher than the 14% rate of Hispanics.
Some experts wonder if Black patients with dementia are suffering from causes other than Alzheimer’s, or if the illness develops differently in varied populations with higher incidences of chronic disorders.
The beta-amyloid difference adds to evidence that some health indicators may not operate as well in diverse communities as they do in white individuals.
Leqembi will be available for $26,500 per year after receiving complete US regulatory approval last month.
According to a spokeswoman for the US Food and Drug Administration, the agency is aware that some African Americans may be excluded from the new therapy due to insufficient amyloid levels.
According to the spokeswoman, the FDA encourages companies to enroll more diverse groups in current trials. The FDA advised that organizations submit a diversity plan for enrollment in April 2022.
