The Geriatrician, the Primary Care Physician, Aducanumab and the FDA Decision: From Frustration to New Hope

Abstract

Alzheimer is a severe disease and new therapies are really needed. After the development of symptomatic drugs 30 years ago, our objective is to develop disease modifying treatment using anti-amyloid therapies over an 18-month period. First we targeted mild to moderate AD, probably at a too severe stage. Later we targeted mild dementia and when biomarkers became available, we realized that almost 30% of our patients had no amyloid deposit and probably did not have Alzheimer’s disease (1, 2). Then, we started to target early and mild AD defined with amyloid deposit using CSF and PET biomarkers, but our drug dosage was probably not high enough (3, 4). And finaly with the Aducanumap studies we observed some effects with high doses (5, 6). On June 7, 2021 for the first time, the FDA approved a disease modifying drug, Aducanumap. After decades of research, it is good news for patients, and those dedicated to the field, but it is also a challenging time with some frustrations and some hope. In the present JNHA editorial we will review the FDA statement and the consequences for geriatricians and primary care physicians, from frustration to new hope.