Nearly all adults with Down syndrome will develop indications of Alzheimer’s Disease (AD) by as early as 40 years old, including amyloid plaque on the brain. Lecanemab is a drug designed to target and remove amyloid plaque, and recently approved by the U.S. Food and Drug Administration.
However, people with Down syndrome have regularly been excluded or underrepresented in clinical trials of new AD drug therapies. But a new study recently published in the Journal of the American Medical Association Neurology tested lecanemab to see if it could bind to amyloid plaques in brain tissue samples from people with Down syndrome and found that it effectively targeted amyloid in all 15 samples. However, the drug also bound to brain blood vessels in people with Down syndrome raising safety concerns for potential brain hemorrhages and swelling compared to the general population.
“Our findings underscore the exciting promise of anti-amyloid drugs for helping people with Down syndrome, but also the need for careful consideration of safety, especially the risk of hemorrhagic complications,” said Elizabeth Head, PhD, of the Department of Pathology and Laboratory Medicine at University California, Irvine, and co-corresponding author of the study.
The results show that Lecanemab should be rigorously tested in clinical trials for Alzheimer’s Disease in the Down syndrome population to determine its safety and efficacy, especially in those older than 43 years. The research also opens avenues for early intervention strategies that could improve the quality of life for people with Down syndrome at risk of Alzheimer’s disease.