1 00:00:04,800 --> 00:00:07,640 Speaker 1: On this episode of This World Say. Company and Biogen 2 00:00:07,920 --> 00:00:12,160 Speaker 1: announced in January sixth that under the Accelerated Approval pathway, 3 00:00:12,520 --> 00:00:17,880 Speaker 1: the US Food and Drug Administration FDA has approved leacanamab IRMB, 4 00:00:18,239 --> 00:00:20,959 Speaker 1: which has the brand name in the US Laquembi, for 5 00:00:21,000 --> 00:00:24,159 Speaker 1: the treatment of Alzheimer's disease. The approval is based on 6 00:00:24,239 --> 00:00:28,360 Speaker 1: Phase two data that demonstrated that Laquembe reduced the accumulation 7 00:00:28,360 --> 00:00:32,600 Speaker 1: of plaque in the brain, a defining feature of Alzheimer's disease. 8 00:00:33,200 --> 00:00:36,720 Speaker 1: Using the recently published data from the large global confirmatory 9 00:00:36,720 --> 00:00:40,840 Speaker 1: Phase three clinical trial, Clarity, A d SA will work 10 00:00:40,960 --> 00:00:45,000 Speaker 1: quickly to file a supplemental Biologic's license application to the 11 00:00:45,040 --> 00:00:48,879 Speaker 1: FDA for approval under the traditional pathway. Here to talk 12 00:00:48,920 --> 00:00:53,280 Speaker 1: about this remarkable breakthrough for Alzheimer's disease treatment, I'm really 13 00:00:53,360 --> 00:00:56,960 Speaker 1: pleased to welcome my guest. Doctor Marwe Saba, who I 14 00:00:57,040 --> 00:00:59,920 Speaker 1: first worked with back in two thousand and eight, is 15 00:01:00,080 --> 00:01:03,880 Speaker 1: a behavioral neurologists and the Alzheimer's Memory Disorders Program and 16 00:01:03,960 --> 00:01:07,839 Speaker 1: a professor in the Department of Neurology at Barrow Neurological Institute, 17 00:01:08,080 --> 00:01:19,240 Speaker 1: and as one of the leading doctors on the study. Marlin, 18 00:01:19,560 --> 00:01:22,560 Speaker 1: thank you for joining me on news World. It's nice 19 00:01:22,600 --> 00:01:25,040 Speaker 1: to talk to you again, and I'm glad you're still 20 00:01:25,200 --> 00:01:28,320 Speaker 1: passionate about Alzheimer's. What let you have such a deep 21 00:01:28,400 --> 00:01:33,000 Speaker 1: passionate interest in Alzheimer's and in dementia. Yes, so it 22 00:01:33,200 --> 00:01:35,760 Speaker 1: doesn't run in my family. I had a fear of 23 00:01:35,760 --> 00:01:39,120 Speaker 1: getting old, and I thought that Alzheimer's was the embodiment 24 00:01:39,120 --> 00:01:42,520 Speaker 1: of everything sad and destructive about getting old. Fortunately, I've 25 00:01:42,520 --> 00:01:45,240 Speaker 1: been cured of that. I am very optimistic about the 26 00:01:45,240 --> 00:01:48,640 Speaker 1: future of aging, the future of Alzheimer's, and so that's 27 00:01:48,840 --> 00:01:51,240 Speaker 1: how I got in Alzheimer's. Could you just take a 28 00:01:51,280 --> 00:01:54,720 Speaker 1: minute talk to us about what is Alzheimer's. So people 29 00:01:55,000 --> 00:01:58,680 Speaker 1: understand Alzheimer's as the dementia phase. The dementia phase meaning 30 00:01:58,960 --> 00:02:02,680 Speaker 1: your cognitive memory disorders and memory issues get so bad 31 00:02:02,680 --> 00:02:05,440 Speaker 1: it starts to affect your daily life. That is dementias. 32 00:02:05,440 --> 00:02:08,960 Speaker 1: So dementia means you've lost your independence because of cognitive decline. 33 00:02:09,360 --> 00:02:12,359 Speaker 1: Dementia is a categorical definition, so there are many cause 34 00:02:12,440 --> 00:02:15,679 Speaker 1: of dementia. Alzheimer's is the most common type of dementia. 35 00:02:15,919 --> 00:02:18,800 Speaker 1: Two thirds of all dementia's Alzheimer's, but it is an 36 00:02:18,840 --> 00:02:21,880 Speaker 1: accumulation of proteins that should not be accumulating your brain. 37 00:02:22,240 --> 00:02:26,160 Speaker 1: The two main proteins are amaloid and and they accumulate 38 00:02:26,200 --> 00:02:30,079 Speaker 1: for twenty years before your first day ofgetfulness, So by 39 00:02:30,080 --> 00:02:31,920 Speaker 1: the time you walk into my clinic, your brain is 40 00:02:31,919 --> 00:02:35,680 Speaker 1: full of Alzheimer changes. What is the protein beta amyloid? 41 00:02:36,120 --> 00:02:40,880 Speaker 1: The protein beta amyloid is a protein that normally is 42 00:02:40,880 --> 00:02:43,840 Speaker 1: cleared out of the brain when it's a different form 43 00:02:43,880 --> 00:02:47,880 Speaker 1: of it. But when it starts to form the Alzheimer amoloid, 44 00:02:47,960 --> 00:02:51,200 Speaker 1: which is a forty two amino acid protein, it does 45 00:02:51,280 --> 00:02:53,720 Speaker 1: not clear out of the brain. It starts to accumulate 46 00:02:53,960 --> 00:02:56,840 Speaker 1: and stick together and clump together. And when it starts 47 00:02:56,840 --> 00:02:59,560 Speaker 1: to get to a certain stage of clumping together and 48 00:02:59,680 --> 00:03:03,359 Speaker 1: starts to damage that accumulation starts to damage the cells, 49 00:03:03,560 --> 00:03:08,440 Speaker 1: and then you get inflammatory changes and inflammatory reactions, and 50 00:03:08,560 --> 00:03:11,480 Speaker 1: the presence of amaloid triggers a whole cascade of other 51 00:03:11,560 --> 00:03:14,600 Speaker 1: things that lead to more problems down the road. So 52 00:03:15,000 --> 00:03:20,440 Speaker 1: amyloid is the earliest important seminal event that leads to 53 00:03:20,520 --> 00:03:24,200 Speaker 1: the downstream problems that ultimately lead to the dementia. And 54 00:03:24,280 --> 00:03:27,760 Speaker 1: then what are the crusted strands of the protein towel. 55 00:03:28,720 --> 00:03:31,600 Speaker 1: The best way to describe TAO is we have inside 56 00:03:31,600 --> 00:03:35,840 Speaker 1: our brain cells these long proteins called microtubules. Think of 57 00:03:36,040 --> 00:03:40,240 Speaker 1: microtubules as railroad tracks, and think of the cross hatches 58 00:03:40,680 --> 00:03:43,480 Speaker 1: as the cross hatches on the railroad tracks keep the 59 00:03:43,480 --> 00:03:47,200 Speaker 1: tracks together moving in the same direction. TAW is those 60 00:03:47,560 --> 00:03:52,560 Speaker 1: cross hatches, So the TAW keeps the microtubules assembled. When 61 00:03:52,600 --> 00:03:58,520 Speaker 1: TAO undergoes a biological change called phosphorylation, those cross hatches 62 00:03:58,520 --> 00:04:02,160 Speaker 1: of towel stop binding to microtubos, and microtubs literally get 63 00:04:02,360 --> 00:04:05,720 Speaker 1: jumbled up, and ultimately the cells die because they can't 64 00:04:05,840 --> 00:04:08,320 Speaker 1: traffic proteins and other things up and down cells. They 65 00:04:08,320 --> 00:04:11,160 Speaker 1: cannot move things inside the cells, and that's what causes 66 00:04:11,200 --> 00:04:13,920 Speaker 1: the cells to die. So the TOWE is these little 67 00:04:13,960 --> 00:04:17,640 Speaker 1: proteins that ultimately then get broken up when the cells die, 68 00:04:17,680 --> 00:04:20,279 Speaker 1: they're released and they're taken up by cells next door. 69 00:04:20,680 --> 00:04:25,720 Speaker 1: And the spread of tow correlates more reliably with cognitive 70 00:04:25,760 --> 00:04:29,560 Speaker 1: decline than the spread of amyloid. Is there any relationship 71 00:04:29,720 --> 00:04:32,960 Speaker 1: between the amyloid and the towel that because one perceived 72 00:04:33,000 --> 00:04:36,240 Speaker 1: the other are They're just parallel, independent developments at the 73 00:04:36,279 --> 00:04:40,719 Speaker 1: beginning that amoloid precedes the TOWE. There's some evidence that 74 00:04:40,839 --> 00:04:44,359 Speaker 1: amoloid is triggering the TOW, which TOWE is more of 75 00:04:44,360 --> 00:04:48,720 Speaker 1: a protein in response to injury. Amoloid is the injuring protein. 76 00:04:49,120 --> 00:04:52,080 Speaker 1: But after a while then they accumulate in parallel. Why 77 00:04:52,080 --> 00:04:56,560 Speaker 1: would somebody at a very early age suddenly have Alzheimer's. 78 00:04:57,080 --> 00:05:00,960 Speaker 1: Those are mostly people with genetic mutations that lead to Alzheimer's, 79 00:05:01,240 --> 00:05:03,160 Speaker 1: and there are a few of them. They're a handful 80 00:05:03,200 --> 00:05:06,640 Speaker 1: of the biggest group of people with young onset Alzheimer's 81 00:05:06,680 --> 00:05:11,400 Speaker 1: diseases down syndrome. They all get Alzheimer's more than eighty 82 00:05:11,480 --> 00:05:14,800 Speaker 1: ninety percent. We'll get Alzheimer's dimension their lifetime. That is 83 00:05:14,800 --> 00:05:18,039 Speaker 1: a good example of young onset Alzheimer's. Well this new 84 00:05:18,920 --> 00:05:23,520 Speaker 1: medicine have any impact on these early onset cases. For 85 00:05:23,600 --> 00:05:26,080 Speaker 1: the most part, we don't know the answer. That. I mean, 86 00:05:26,440 --> 00:05:29,080 Speaker 1: all the focus of the treatments have been around the 87 00:05:29,080 --> 00:05:34,760 Speaker 1: typical Alzheimer person right sixties, seventies, eighties onset. We have not, 88 00:05:35,040 --> 00:05:37,440 Speaker 1: as far as I know, done a lot of work 89 00:05:37,600 --> 00:05:41,680 Speaker 1: with this new treatment in the young onset Alzheimer's. There 90 00:05:41,800 --> 00:05:46,160 Speaker 1: is a study out of Washington University called the Diane Study, 91 00:05:46,480 --> 00:05:49,080 Speaker 1: and they were looking at drugs similar to this to 92 00:05:49,080 --> 00:05:51,080 Speaker 1: treat the young onset. But as far as I know, 93 00:05:51,360 --> 00:05:55,039 Speaker 1: that has not been successful. Alzheimer's for most people, you've 94 00:05:55,080 --> 00:05:59,159 Speaker 1: actually had it for years before it manifest itself in 95 00:05:59,240 --> 00:06:02,400 Speaker 1: any kind of avil modification. Is that accurate? That is 96 00:06:02,440 --> 00:06:05,440 Speaker 1: an accurate statement. So we know that by the time 97 00:06:05,480 --> 00:06:07,880 Speaker 1: you walk into the clinic you may have been accuminting 98 00:06:08,320 --> 00:06:10,960 Speaker 1: you know, amyloid and town in your brain for fifteen 99 00:06:11,080 --> 00:06:14,279 Speaker 1: twenty years or so. So the dementia phase is a 100 00:06:14,360 --> 00:06:18,240 Speaker 1: late manifestation of the ethology. If we can find a 101 00:06:18,279 --> 00:06:22,400 Speaker 1: way to cure Alzheimer's, we have an enormous impact both 102 00:06:22,440 --> 00:06:25,520 Speaker 1: on the quality of life and productivity, and also on 103 00:06:25,560 --> 00:06:28,479 Speaker 1: the physical costs of just the entire of the health system. 104 00:06:29,960 --> 00:06:33,320 Speaker 1: Great summary, exactly right. The last fifteen years have been 105 00:06:34,040 --> 00:06:37,479 Speaker 1: very productive and breakthroughs, and when I was speaker, we 106 00:06:37,839 --> 00:06:40,240 Speaker 1: doubled the size of the NIH budget. This is an 107 00:06:40,279 --> 00:06:43,560 Speaker 1: example of the kind of breakthroughs that are now beginning 108 00:06:43,600 --> 00:06:46,120 Speaker 1: to really pay off in terms of the quality of 109 00:06:46,160 --> 00:06:49,640 Speaker 1: life for Americans. And you led huge initiatives that have 110 00:06:49,800 --> 00:06:53,160 Speaker 1: paid off huge dividends that all the work you led 111 00:06:53,520 --> 00:06:57,200 Speaker 1: led to big funding initiatives that have advanced the fields greatly. 112 00:06:57,320 --> 00:07:20,000 Speaker 1: So thank you. If you think you're at risk for Alzheimers, 113 00:07:20,320 --> 00:07:23,720 Speaker 1: what are the things you can do to slow or 114 00:07:23,800 --> 00:07:27,960 Speaker 1: prevent the progressional disease? In prevention, you know, people are 115 00:07:28,000 --> 00:07:30,360 Speaker 1: looking at the fact that you should be engaging in 116 00:07:30,400 --> 00:07:34,360 Speaker 1: ways to reduce your risk. That would include aggressive blood 117 00:07:34,400 --> 00:07:39,520 Speaker 1: pressure management, cognitive stimulation, brain games or things like that, 118 00:07:39,880 --> 00:07:43,200 Speaker 1: and physical exercise are the three things that have been 119 00:07:43,200 --> 00:07:47,880 Speaker 1: shown that the National Academy of Sciences, Medicine and Engineering 120 00:07:47,960 --> 00:07:51,600 Speaker 1: have sufficient evidence to recommend. The World Health Organization would 121 00:07:51,640 --> 00:07:54,440 Speaker 1: add more to that, and the Lancet Commission would add 122 00:07:54,480 --> 00:07:56,520 Speaker 1: more to that. But we are now looking at the 123 00:07:56,880 --> 00:07:59,720 Speaker 1: concept of brain health in a way to engage people 124 00:07:59,800 --> 00:08:03,200 Speaker 1: to do preventive strategies that they can start today and 125 00:08:03,280 --> 00:08:06,080 Speaker 1: not just wait till they're having problems. Wasn't there a 126 00:08:06,080 --> 00:08:08,840 Speaker 1: study one so I think it was of nuns who 127 00:08:09,440 --> 00:08:12,720 Speaker 1: played bridge versus nuns who didn't, and the just the 128 00:08:12,720 --> 00:08:16,880 Speaker 1: act of playing bridge stimulated their brain and chromatically changed 129 00:08:16,960 --> 00:08:21,720 Speaker 1: the trajectory of brain diseases. That was the Snowdon study 130 00:08:21,760 --> 00:08:24,360 Speaker 1: from University of Kentucky and their nun study from the 131 00:08:24,480 --> 00:08:27,160 Speaker 1: nineteen eighties, and that's exactly right, and that was the 132 00:08:27,240 --> 00:08:32,839 Speaker 1: first evidence of cognitive stimulation. Brain stimulation on a continuous 133 00:08:32,880 --> 00:08:36,200 Speaker 1: basis that has shown to be protective. And we've seen 134 00:08:36,320 --> 00:08:40,160 Speaker 1: multiple studies since then confirming that observation. For our listeners, 135 00:08:40,200 --> 00:08:42,800 Speaker 1: any need to realize this is the sixth leading cause 136 00:08:42,840 --> 00:08:46,560 Speaker 1: of death in nined States. This is a major part 137 00:08:46,640 --> 00:08:49,880 Speaker 1: of our health trajectory. Then the work you're doing is 138 00:08:49,920 --> 00:08:52,000 Speaker 1: a big part of that. And now, for the very 139 00:08:52,040 --> 00:08:55,360 Speaker 1: first time, the Food and Drug Administration is beginning to 140 00:08:55,400 --> 00:08:59,320 Speaker 1: approve drugs in this area, which is tricky because their 141 00:08:59,360 --> 00:09:02,640 Speaker 1: standard acquired a turnaround time that was reasonable. Now, when 142 00:09:02,679 --> 00:09:05,880 Speaker 1: you're dealing with long term brain diseases, the studies take 143 00:09:05,960 --> 00:09:08,480 Speaker 1: so long. You do a lot more damage to people 144 00:09:08,480 --> 00:09:11,080 Speaker 1: by not approving and taking the risks than you do 145 00:09:11,120 --> 00:09:15,000 Speaker 1: by waiting for the ultimately multi year outcome. But they 146 00:09:15,040 --> 00:09:18,040 Speaker 1: have approved six drugs and LAKEMBE is going to be 147 00:09:18,200 --> 00:09:21,000 Speaker 1: number seven. Have you found the FDA to be more 148 00:09:21,080 --> 00:09:24,760 Speaker 1: knowledgeable and more reasonable in this area? I have to 149 00:09:24,800 --> 00:09:27,360 Speaker 1: say that the FDA, because I know a lot of 150 00:09:27,360 --> 00:09:30,920 Speaker 1: those officers at the FDA are paying a lot of attention. 151 00:09:30,960 --> 00:09:36,880 Speaker 1: They're very very well informed, they're very motivated to stay informed, 152 00:09:37,240 --> 00:09:41,560 Speaker 1: and they're listening very carefully to everything. They're very very 153 00:09:41,600 --> 00:09:44,480 Speaker 1: close to the science. When they make decisions. I assure 154 00:09:44,520 --> 00:09:48,720 Speaker 1: you they have really gone through this very carefully, very thoroughly, 155 00:09:49,120 --> 00:09:51,360 Speaker 1: and I know them well enough to know that they're 156 00:09:51,480 --> 00:09:54,000 Speaker 1: very careful people speaker. I think they have a very 157 00:09:54,480 --> 00:09:57,680 Speaker 1: hard job, very difficult job, but they make no mistake 158 00:09:57,720 --> 00:10:00,320 Speaker 1: about it. They're very thorough and very careful. They have 159 00:10:00,360 --> 00:10:02,760 Speaker 1: two challenges. One is to make sure the drug actually 160 00:10:02,760 --> 00:10:04,920 Speaker 1: works and the other is to make sure it doesn't 161 00:10:04,920 --> 00:10:07,960 Speaker 1: do more harm than good. The initial wave of the 162 00:10:08,000 --> 00:10:10,640 Speaker 1: first five drugs that they approved, we're really sort of 163 00:10:10,760 --> 00:10:14,800 Speaker 1: symptom oriented rather than taking Alzheimer's on head on. And 164 00:10:14,880 --> 00:10:18,320 Speaker 1: in terms of changing the course of disease, that's correct. 165 00:10:18,360 --> 00:10:20,480 Speaker 1: It would be like tilenol for a fever. These are 166 00:10:20,760 --> 00:10:24,080 Speaker 1: drugs that improve the symptoms but don't stop the progression 167 00:10:24,320 --> 00:10:27,960 Speaker 1: or substantly change the disease. And so this new drug, 168 00:10:28,120 --> 00:10:31,440 Speaker 1: look CAMBI, being the second one to what we call DMT, 169 00:10:31,600 --> 00:10:35,160 Speaker 1: or disease modifying treatment, is a real game changer. Look 170 00:10:35,200 --> 00:10:38,560 Speaker 1: CAMBI as an additional break in that direction. You are 171 00:10:38,600 --> 00:10:41,280 Speaker 1: a researcher on a study for the new drug, how 172 00:10:41,280 --> 00:10:45,600 Speaker 1: does it differ from prior drugs? So what the drug 173 00:10:45,800 --> 00:10:49,960 Speaker 1: does is it's called a biologic or a monoclonal antibody. 174 00:10:50,280 --> 00:10:54,520 Speaker 1: And understand that monoclon antibodies are manufactured proteins that you 175 00:10:54,679 --> 00:10:59,120 Speaker 1: inject or infuse, and they're basically there to find whatever 176 00:10:59,160 --> 00:11:03,400 Speaker 1: their design to find. Right. So Lakembi is a manufactured 177 00:11:03,440 --> 00:11:07,360 Speaker 1: protein and it's designed to find amyloid and grab it 178 00:11:07,400 --> 00:11:09,640 Speaker 1: and take it out of the body. That's all it does. 179 00:11:10,040 --> 00:11:13,240 Speaker 1: They understand that, you know, biologics or monoclone lanibodies are 180 00:11:13,320 --> 00:11:15,680 Speaker 1: used in all kinds of diseases. Right you watch TV 181 00:11:15,800 --> 00:11:19,280 Speaker 1: and you talk about sooriasis and arthritis. Those are all 182 00:11:19,360 --> 00:11:23,000 Speaker 1: monoclone lanibodies, much like la Kembi is for Alzheimers. So 183 00:11:24,240 --> 00:11:27,280 Speaker 1: this is a manufactured protein binds amoid, finds it and 184 00:11:27,320 --> 00:11:29,439 Speaker 1: clears it out of the body and out of the brain, 185 00:11:29,640 --> 00:11:32,720 Speaker 1: and it does it spectacularly well. That clarity study that 186 00:11:32,760 --> 00:11:36,440 Speaker 1: you mentioned your opening remark removes ninety percent of the 187 00:11:36,400 --> 00:11:38,520 Speaker 1: amoloid out of your brain in less than twelve months, 188 00:11:38,520 --> 00:11:40,679 Speaker 1: So we know it does what it's supposed to do. 189 00:11:41,120 --> 00:11:43,520 Speaker 1: After you've achieved that in the first twelve months, do 190 00:11:43,559 --> 00:11:46,920 Speaker 1: you need to keep taking it to continue draining out 191 00:11:47,040 --> 00:11:50,160 Speaker 1: the harmful transitions or can you sort of back off 192 00:11:50,200 --> 00:11:53,359 Speaker 1: for a while because you've relieved ninety percent of them. 193 00:11:53,480 --> 00:11:55,880 Speaker 1: It's a speculative thing. In the labels say that you 194 00:11:55,920 --> 00:12:00,360 Speaker 1: will continue to intravenous infusions every two weeks in definite lead, 195 00:12:00,520 --> 00:12:04,000 Speaker 1: and that's the state of the science right now. You know, 196 00:12:04,040 --> 00:12:06,400 Speaker 1: a year from now that might change. What I think's 197 00:12:06,400 --> 00:12:08,600 Speaker 1: going to happen, though, is you'll take it for a 198 00:12:08,679 --> 00:12:12,600 Speaker 1: year or two IV. This is speculative. I'm not speaking 199 00:12:12,640 --> 00:12:15,800 Speaker 1: on anybuddy's authority. Right then you'll either go to a 200 00:12:15,880 --> 00:12:19,400 Speaker 1: shot like an injection every once in a while, or 201 00:12:19,440 --> 00:12:22,200 Speaker 1: you'll just get it less often. So I think the 202 00:12:22,280 --> 00:12:25,000 Speaker 1: IV every two weeks will just be on the short term, 203 00:12:25,280 --> 00:12:28,240 Speaker 1: but we don't have a definitive position on that yet. 204 00:12:28,280 --> 00:12:31,320 Speaker 1: And then how long does the intravendis treatment take. It 205 00:12:31,320 --> 00:12:33,680 Speaker 1: takes about an hour to take the treatment, so you 206 00:12:33,720 --> 00:12:36,319 Speaker 1: go to a clinic, yes, okay, but for an hour 207 00:12:36,400 --> 00:12:39,760 Speaker 1: every two weeks. If we're clearing up nine, what could 208 00:12:39,920 --> 00:12:43,000 Speaker 1: lead you to have real cognitive problems. That's a pretty 209 00:12:43,000 --> 00:12:46,360 Speaker 1: good trade. Absolutely. And if you were at the beginning 210 00:12:46,360 --> 00:12:49,079 Speaker 1: of the Alzheimer process what we call mild cogning repairment 211 00:12:49,200 --> 00:12:52,720 Speaker 1: or pre dementia, and you're still independent but you're having 212 00:12:52,760 --> 00:12:55,640 Speaker 1: some memory issues, wouldn't it be awesome that you don't 213 00:12:55,679 --> 00:12:58,280 Speaker 1: go on to get dementia. You're still independent, you still 214 00:12:58,360 --> 00:13:01,920 Speaker 1: enjoy your call of life, and this drug slows the 215 00:13:02,040 --> 00:13:06,679 Speaker 1: progression to dementia. People can continue independent living, probably continue 216 00:13:06,720 --> 00:13:09,559 Speaker 1: to work if they want to. It's really a game changer. 217 00:13:10,080 --> 00:13:12,319 Speaker 1: But as I understand it, you have to be in 218 00:13:12,440 --> 00:13:17,280 Speaker 1: fairly early stages for this to work. Yes, this is 219 00:13:17,320 --> 00:13:20,720 Speaker 1: a drug that unfortunately not everybody's going to get. The 220 00:13:20,880 --> 00:13:24,640 Speaker 1: data is very clearly suggest that only the people at 221 00:13:24,679 --> 00:13:28,520 Speaker 1: the beginning stages, so mild cognment, impairment, or mild dementia, 222 00:13:28,840 --> 00:13:32,719 Speaker 1: will be appropriate for this. If you're more advanced in 223 00:13:32,800 --> 00:13:37,360 Speaker 1: your dementia, if you don't have amyloid, if you have 224 00:13:37,480 --> 00:13:40,320 Speaker 1: a pacemaker and you can't get an MRI, A lot 225 00:13:40,320 --> 00:13:43,040 Speaker 1: of people will not get the drug. Speaker, I have 226 00:13:43,120 --> 00:13:46,199 Speaker 1: to tell you that our estimates only suggested maybe twenty 227 00:13:46,240 --> 00:13:48,360 Speaker 1: percent of people walking in the door will get the drug. 228 00:13:48,559 --> 00:13:51,800 Speaker 1: And most people will not if you have any sense 229 00:13:52,760 --> 00:13:56,320 Speaker 1: that you're beginning to have cognitive impairment. The earlier you 230 00:13:56,400 --> 00:13:59,440 Speaker 1: are diagnosed, the greater the likelihood that you could get 231 00:13:59,480 --> 00:14:04,280 Speaker 1: a drug this to dramatically postpone the onset of serious 232 00:14:04,320 --> 00:14:08,240 Speaker 1: cognitive problems. That is exactly right, and we expect to 233 00:14:08,280 --> 00:14:11,360 Speaker 1: see that. And the other thing that we're seeing that's 234 00:14:11,400 --> 00:14:15,440 Speaker 1: coming to the market now is a possibility of a 235 00:14:15,559 --> 00:14:19,120 Speaker 1: screening blood test like a PSA. Like you and I 236 00:14:19,160 --> 00:14:22,480 Speaker 1: as men, we always go get our pay check. We 237 00:14:22,560 --> 00:14:25,800 Speaker 1: might have a screening blood test that's actually coming to 238 00:14:25,800 --> 00:14:28,400 Speaker 1: the clinic as we speak. So I'm not sure it'd 239 00:14:28,400 --> 00:14:30,720 Speaker 1: be a diagnostic, you know, like you just go get 240 00:14:30,760 --> 00:14:33,720 Speaker 1: your infusion after the blood test, But if it's normal, 241 00:14:33,840 --> 00:14:36,320 Speaker 1: then you know you don't have Alzheimers, and if it's admirable, 242 00:14:36,440 --> 00:14:39,360 Speaker 1: you could get more testing. So that is also a 243 00:14:39,360 --> 00:14:41,480 Speaker 1: big development in the field. And we could be using 244 00:14:41,520 --> 00:14:44,680 Speaker 1: the screening blood test later this year. So a lot 245 00:14:44,720 --> 00:14:48,160 Speaker 1: of big changes in twenty twenty three, which offers enormous 246 00:14:48,160 --> 00:14:51,400 Speaker 1: hope in the long run. It's the point at which 247 00:14:51,400 --> 00:14:55,760 Speaker 1: the onset begins, not your age. So if you're sixty 248 00:14:55,800 --> 00:14:59,000 Speaker 1: an early onset. You should get checked immediately. If you're 249 00:14:59,080 --> 00:15:01,800 Speaker 1: eighty or ninety and you suddenly have on said, you 250 00:15:01,840 --> 00:15:04,840 Speaker 1: still are treatable if they caught early enough. So it 251 00:15:04,880 --> 00:15:08,680 Speaker 1: really does create sort of a wave effect that as 252 00:15:08,720 --> 00:15:11,640 Speaker 1: people get better at this, we begin to cut off 253 00:15:12,320 --> 00:15:14,400 Speaker 1: by countering it. In the first year or two or 254 00:15:14,440 --> 00:15:19,760 Speaker 1: three people becoming seriously impaired. Yes, that's correct, which is 255 00:15:19,880 --> 00:15:24,760 Speaker 1: an enormous revolution. Yes, absolutely. Let me ask you a 256 00:15:24,760 --> 00:15:28,040 Speaker 1: closing question, which is what would you say to people 257 00:15:28,240 --> 00:15:31,840 Speaker 1: who are worried about Alzheimer's and the possibility of the 258 00:15:31,880 --> 00:15:35,320 Speaker 1: great breakthroughs that are coming. Speaker, you have had a 259 00:15:35,440 --> 00:15:39,440 Speaker 1: major impact on American society over the last thirty years, 260 00:15:39,720 --> 00:15:44,160 Speaker 1: and I'm telling you that because you saw under your 261 00:15:44,320 --> 00:15:49,640 Speaker 1: watch the transformation of other diseases. Right, So, in your time, 262 00:15:50,040 --> 00:15:54,280 Speaker 1: you saw HIV turn from a terminal disease to now 263 00:15:54,280 --> 00:15:59,120 Speaker 1: a chronic, manageable disease. You saw multiple sclerosis turned from 264 00:15:59,600 --> 00:16:01,560 Speaker 1: a disease where you were going to be in a 265 00:16:01,600 --> 00:16:04,480 Speaker 1: wheelchair for sure in ten years to now people live 266 00:16:04,520 --> 00:16:07,840 Speaker 1: a normal quality of life. I start with that because 267 00:16:07,920 --> 00:16:10,600 Speaker 1: we are now going to see that happen with Alzheimers. 268 00:16:10,800 --> 00:16:12,600 Speaker 1: It will go from a terminal disease as you and 269 00:16:12,640 --> 00:16:14,760 Speaker 1: I know it. We've invested much of our careers in this, 270 00:16:15,160 --> 00:16:18,000 Speaker 1: to a chronic disease. One day in the very near future, 271 00:16:18,640 --> 00:16:20,800 Speaker 1: you will have a little bit of forgetfulness. You'll go 272 00:16:20,800 --> 00:16:23,680 Speaker 1: get your blood tests, you'll go get your confirmation, pet 273 00:16:23,720 --> 00:16:26,640 Speaker 1: scans and things like that. Start on a cocktail regiment, 274 00:16:26,760 --> 00:16:29,360 Speaker 1: you know, one, two, three, four or five drug approach, 275 00:16:29,720 --> 00:16:31,560 Speaker 1: and then you won't get worse and you'll have a 276 00:16:31,600 --> 00:16:34,920 Speaker 1: normal life. And that day is coming soon. And so 277 00:16:35,240 --> 00:16:37,800 Speaker 1: I am very excited about leken because it is the 278 00:16:37,840 --> 00:16:42,120 Speaker 1: beginning the transformation of Alzheimer's from a criminal disease as 279 00:16:42,160 --> 00:16:44,200 Speaker 1: you and I know it, to a chronic disease. I 280 00:16:44,240 --> 00:16:46,080 Speaker 1: want to thank you for joining me, and I think 281 00:16:46,080 --> 00:16:48,440 Speaker 1: the work you're doing to find a treatment for Alzheimer's 282 00:16:48,440 --> 00:16:51,840 Speaker 1: disease is so important for all Americans. And I'm looking 283 00:16:51,880 --> 00:16:54,960 Speaker 1: forward clearing about the next great breakthrough, and I look 284 00:16:54,960 --> 00:16:57,520 Speaker 1: forward to you coming back and joining to talk again 285 00:16:57,880 --> 00:17:04,960 Speaker 1: about what's happening. Thank you. Thank you to my guest 286 00:17:05,119 --> 00:17:07,919 Speaker 1: doctor Marjuan Saba. You can find out more about the 287 00:17:07,960 --> 00:17:12,000 Speaker 1: new Alzheimer's disease treatment Lacuimbie on our show page at 288 00:17:12,080 --> 00:17:15,320 Speaker 1: newsworld dot com. News World is produced by Gangwish three 289 00:17:15,480 --> 00:17:20,600 Speaker 1: sixty and iHeartMedia. Our executive producer is Garnsey Slope, our 290 00:17:20,640 --> 00:17:24,320 Speaker 1: producer is Rebecca Hell, and our researcher is Rachel Peterson. 291 00:17:24,680 --> 00:17:27,719 Speaker 1: The artwork for the show was created by Steve Pendley. 292 00:17:28,280 --> 00:17:31,360 Speaker 1: Special thanks to the team at Dinguish three sixty. If 293 00:17:31,400 --> 00:17:33,919 Speaker 1: you've been enjoying Newsworld, I hope you'll go to Apple 294 00:17:33,960 --> 00:17:37,159 Speaker 1: Podcasts and both rate us with five stars and give 295 00:17:37,240 --> 00:17:40,040 Speaker 1: us a review so others can learn what it's all about. 296 00:17:40,520 --> 00:17:43,600 Speaker 1: Right now, listeners of Newtsworld can sign up for my 297 00:17:43,720 --> 00:17:47,639 Speaker 1: three free weekly columns at Gangwish three sixty dot com 298 00:17:47,640 --> 00:17:51,480 Speaker 1: slash newsletter. I'm new Gangwish. This is Newsworld.