New Alzheimer's drug approved in the EU: who will it help in Luxembourg?

Last week, the European Commission approved the use of Lecanemab, the first drug in the EU to target the mechanisms of Alzheimer's disease rather than the symptoms. The drug is a monoclonal antibody that fights amyloid deposits in the brain. But - an important clarification - only in the early stages of the disease.

That is, it is not about miraculous recovery, but about slowing cognitive decline in patients with mild memory and thinking disorders.

The Alzheimer's Association Luxembourg emphasises that Lecanemab can only be used if amyloid pathology is proven, and in some cases genetic testing for the ApoE4 allele, a risk factor associated with predisposition to the disease, is required.

A rigorous assessment of benefits and risks is also necessary, as possible side effects include swelling and brain haemorrhage, which can be life-threatening. It should therefore only be prescribed under careful medical supervision and should be part of a comprehensive approach, including psychological support, early diagnosis and work with families.

Lecanemab is not yet available for general practice in Luxembourg. The drug has been approved at EU level, but the country is still awaiting the decision of the "Commission of Experts" at the Ministry of Health, which will determine the conditions for prescribing, supply and reimbursement.

As explained by the Ministry, only then will the manufacturer be able to request a price and the drug will be added to the list of those reimbursed by the National Health Fund (CNS). Until then, it can only be obtained by individual authorisation through a treating physician: the physician submits an application and the CNS and the Medical Control must approve it.

There is almost no data on the prevalence of Alzheimer's disease in Luxembourg. The only estimate is Alzheimer Europe for 2018: at that time, there were about 7,539 people with dementia in the country, of whom about 5,000 had Alzheimer's disease. But how many of them are at an early stage and fulfil the genetic and clinical criteria is unknown.

The association itself says few patients will benefit from the drug, even with approval.