Learning Lessons from the Past to Improve Future Outcomes

2024 was another groundbreaking year for Alzheimer’s diagnostics and treatments, bringing the promise of early and accurate diagnosis and effective treatments accessible globally closer to a reality. 

In July the U.S. Food and Drug Administration (FDA) approved the country’s third disease modifying treatment — Kisunla (donanemab). Subsequently the treatment received approval in Japan and the UK. Additionally, Leqembi (lecanemab) is being marketed in the U.S., Japan, China, South Korea, Hong Kong, Israel, the United Arab Emirates and the UK. And in the last few week Leqembi has been approved for use in the European Union by the EMA. The manufacturers of both medications have additional applications pending approval across the globe.

Also in 2024 emerging research on blood based biomarkers brought the promise of a simple, cost-effective, and accurate diagnostic closer to doctors’ offices.

These treatment and diagnostic advancements as well as more in the pipeline mark a fundamental change for the field and overtime the experience and care of people with dementia. Importantly the field, health systems, insurers and governments must be ready for this moment — and as leaders in the field we must ensure the benefits of these advancements are not limited to just the richest nations.

While there are many unknowns in the years ahead one thing is certain — there are immeasurable lessons to be learned from the first three years of Alzheimer’s treatment. Where treatments have been approved rollout has been slow and there are many factors to blame and areas to correct. Are there enough neurologists, geriatricians and other prescribing specialists in enough diverse areas to diagnosis and prescribe these treatments? Do insurers and other payers understand these benefits, and will they cover these treatments? Are infusion canters prepared to treat patients and with subcutaneous administration on the near horizon what new challenges await the field? 

We also know treatments are only for those living with early Alzheimer’s disease, in stages 3 and 4 per FDA guidance and the Alzheimer’s Association Criteria (2024). Also known as mild cognitive impairment due to AD or mild Alzheimer’s dementia per older criteria (2018). Are care providers, specifically those most likely to see the signs of dementia or diagnose Alzheimer’s prepared with the knowledge to determine who is eligible? Testing patients for their APOE status may help individuals decide if these treatments are right for them. This testing is allowed and even encouraged in some countries but not approved in others. How will the field adapt to these discrepancies and most importantly how will they help guide patients through the decision-making process on if these treatments are right for them?  

Additionally, registries such as ALZNET will provide the field with additional real-world data and understandings of these treatments. And we’ll learn more about long-term treatment plans as maintenance dosing and decisions to take patients off the treatments continues to evolve.   

These lessons and more will be explored in depth in a series of virtual dialogues hosted by the World Dementia Council next year. 

Together we are co-chairing the first of three virtual dialogues for global experts to explore the early lessons and help shape a policy paper that will be published in 2025. These dialogues will bring together leading researchers, industry, policymakers and advocates to discuss current challenges and explore collaborative opportunities within the region.

Learn more about the series:

Dialogue 1 — Lessons from Treatment: 23 January 2025

  • In the first dialogue, we’ll bring together international experts to explore early lessons from the delivery of treatments to patients who have a diagnosis of Alzheimer’s disease. The session will feature opening remarks by Professors Gil Rabinovici, Reisa Sperling, Donna Wilcock and Dr Cath Mummey. 

Dialogue 2 — Lessons from Advocacy: 27 February 2025

  • Co-chaired by Joanne Pike and George Vradenburg, this session will explore the lessons for advocacy movements from the roll out of the first treatments for Alzheimer's disease. The meeting will explore why treatments were adopted by some countries but not in others and how national and international advocacy organizations should respond. 

Dialogue — Lessons for Health Systems: 3 March 2025

  • Co-chaired by Prof. Mark McCellan and Hilary Evans-Newton, this final session will examine the role of health systems in diagnosing and treating people living with dementia. Health systems in the U.S. were unprepared for treatments, and low-and middle-income nations will have their own unique challenges. Speakers for this event will highlight the challenges and pose solutions. 

The discussions will culminate at the 2025 WDC Summit held on 25 March 2025 in London.