“I lose my keys all the time,” Bob Lathrop says, only half joking. He’s one of six people participating in a new clinical Alzheimer’s prevention study being performed at the Cleveland Clinic Lou Ruvo Center for Brain Health in Las Vegas. “My Mom was diagnosed 15, 20 years ago,” Lathrop adds.
Named AHEAD, the study aims to stop the progression of a disease that, according to the Alzheimer’s Association, an estimated 6.7 million (or one in nine) Americans 65 and older are living with.
Lathrop doesn't yet have Alzheimer’s or any of the symptoms, such as memory loss or disorientation, besides losing his keys often. But clinically, he has some risk factors. “They determined that I do have plaque on my brain, even though I don't have any cognitive disability,” he says. Because of this, he’ll be going to the Lou Ruvo Center every two weeks for the next six months to get a lecanemab infusion — it’s a painless process that allows him to return to work later that day without any interruption.
Lecanemab’s lack of discomfort is only part of the revolutionary nature of this trial. According to the Lou Ruvo Center, it’s the first Alzheimer’s drug to be granted traditional FDA approval in more than 20 years, and is among the first in a new class of drugs proven to slow the progression of the disease. One of the reasons for this slow pace is the complexity of Alzheimer’s, which can be detected when the brain shows a growth of proteins, called amyloid, similar to plaque on your teeth. In people with advanced stages of Alzheimer's, that plaque has turned into tau, similar to a cancer that has metastasized. Medications like lecanemab work by slowing down this protein growth process. It's not a cure, but it is an incredible medical accomplishment, one that Las Vegas is part of: The Lou Ruvo Center is the only location in Nevada participating in the global AHEAD trial for the drug.
Charles Bernick, a neurologist leading the study in Las Vegas, says everyone has the presence of this amyloid protein, which the body essentially flushes out naturally. But Alzheimer's causes the protein to overproduce in some people. “Then, it just accumulates,” he says. “It's like having a sink that starts to clog up and you can't get rid of the water. And amyloid has this peculiar property, it likes to clump together. So, it aggregates and forms a plaque.”
Those at highest risk for these plaques are the elderly, women, and people with a family history of the disease, like Bob Lanthrop. “There's a big difference between forgetting where you put your keys and not recognizing the people in your life,” Lathrop says. That's not to say he wasn't concerned when he found out he was “clinically eligible.” “My first thought was, ‘Crap. I've got it,’” he recalls. But, through leaning on his family and faith, he says he found a certain peace with this new information. “It is what it is. I mean I could get hit by a truck next week, too. Nobody knows, but you’ve got to stay positive.”
Bernick considers the medication a “breakthrough” in treating patients like Lathrop, before tau develops. He says, “If you start early enough in the disease process — and we do have the ability now with the technology to determine who has Alzheimer's up to 10 years before they have symptoms — the thought is that we can actually prevent or certainly delay someone from getting from a moderate to a severe stage.” He hopes that testing for proteins associated with Alzheimer’s can become commonplace in the future as part of regular blood tests and physicals.
For now, Bernick would like to have more diversity in people willing to participate in clinical studies, as well as greater interest in general — he wants to double the half-dozen people currently enrolled. Because the FDA has given lecanemab traditional approval, the cost of the diagnosis and treatment can now be covered by Medicare, for those participating in an approved clinical study. Without insurance, the cost can easily exceed $20,000.
Bob Lathrop knows he can't help his mom. But he may be able to slow the progression for himself, if he begins showing signs of this dreaded condition. More importantly, to him, his participation may help his children or grandchildren. “Regular people like you and me can help move science forward.”
For more information you can visit healthybrains.org/AHEAD or call 702-701-7944.
