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misinformation about Aduhelm for Alzheimer’s – Boston, Massachusetts

Boston, Massachusetts 2021-07-21 13:27:27 –

SSurgeon General Bibek Mercy unveiled something timely and thought-provoking Advisory A serious threat to public health posed by false information about the July 15 Covid-19 pandemic. Just two days later, the New York Times chose to place a embarrassing ad on its page about yet another global public health challenge, Alzheimer’s disease. This ad contains exactly the elements of “false, inaccurate, or misleading” information that surgeons generally warn.

“When memory fades” A sophisticated paid post telling the story of Jane, a 76-year-old woman diagnosed with Mild Cognitive Impairment (MCI) due to Alzheimer’s disease. The post was paid by Biogen and created by the New York Times’ Brand Marketing Department. It encourages readers to follow Jane’s example in overcoming the stigma associated with cognitive decline and fear of diagnosing Alzheimer’s disease. It contrasts memory-impaired patients who may hesitate to seek medical advice with those with heart disease who “tend to see a doctor before a heart attack occurs.”

Prominently displayed in this paid post is a fairly emphasized claim that “about 1 in 12 Americans over the age of 50 suffers from MCI due to Alzheimer’s disease.” I have not quoted the source of this statistic, which is clearly incorrect. According to 2021 “Facts and numbers of Alzheimer’s disease” A report published in its own journal by the Alzheimer’s Association states that “the number and proportion of older people suffering from MCI due to Alzheimer’s disease requires population-based prevalence measurements of MCI and Alzheimer’s biomarkers. Currently difficult to estimate. These studies were in their childhood. “

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However, it is possible to derive indirect estimates from relatively small studies involving patients with mild cognitive impairment and biomarkers for Alzheimer’s disease. Using this approach, Alzheimer’s Disease Association says “About 8% of people over the age of 65, or about 5 million older Americans, may have MCI because of Alzheimer’s disease.” However, this prevalence estimate is “bio. It needs to be confirmed in a population-based study that includes markers. “

The prevalence of “about 8%” of mild cognitive impairment due to Alzheimer’s disease in people “aged 65 and over” fits Biogen’s misleading claim and appears to pose this risk to a fairly young population.

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Biogen’s ad concludes with the advice Jane and her husband Jim have among us who have “undiagnosed MCI.”

It’s not entirely clear how someone can identify someone with “undiagnosed MCI,” but the link at the end of the ad provides additional clues. The URL appears on a web page hosted by Biogen and its partner Eisai. itstimeweknow.com.. It is intended to provide detailed information about mild cognitive impairment due to Alzheimer’s disease.There is also Companion Facebook page The same name, which claims that “more than 9 million Americans live with MCI because of Alzheimer’s disease,” almost doubles the Alzheimer’s Association estimate.

The timeweknow website warned ominously that “Alzheimer’s disease can take up to 20 years before symptoms appear,” and “about 1 in 12 Americans over the age of 50 has Alzheimer’s disease MCI. I’m requoting the misleading number “I have the earliest clinical stage-that’s the stage.” Symptoms will become more noticeable. The website also offers multiple-choice “symptom quizzes” that allow users to forget their appointments, lose their thoughts, or have trouble finding the right words during a conversation. You can report how often you experience symptoms such as. It then displays the answers to six questions and provides guidance, perhaps based on the severity of the symptoms.

You can take the quiz multiple times. I received it twice — first select the “frequently” option for all questions, then never select the “never” option. Surprisingly, the advice for both scenarios was to ask the doctor “whether cognitive screening is right for you”.

The advice from completing the same screening test by answering all the questions “frequently” (left) and “never” (right) was the same. Image courtesy of Madhav Thambisetty

Websites also enable one Find the nearest Alzheimer’s disease specialist If they or their loved ones are concerned about mild cognitive impairment due to Alzheimer’s disease, such as “neurologist or geriatrician”. However, among the choices of the “Specialist” center, a rheumatism clinic with 10 years of experience specializing in “rheumatism, autoimmunity, bone and joint conditions” management and infusion services was offered. Veins needed for Aduhelm, Biogen’s new Alzheimer’s disease drug.

Also, itstimeweknow’s website measures levels in the nearest center that provides lumbar puncture to measure the level of a protein called amyloid that is somehow involved in Alzheimer’s disease in the spinal fluid, or in the brain. You can find a PET scanning facility for. Both tests help identify “amyloid positivity” (high levels of amyloid, a protein that aducanumab lowers). It was not because of the apparent slowdown in memory loss in patients with Alzheimer’s disease, but because of this decline in cerebral amyloid. FDA approval of Aduhelm..

As a neurologist, I have performed lumbar punctures on many patients, but I have not yet met anyone who has requested this procedure myself.

Diagnosis of mild cognitive impairment is not easy. Specialists often find it difficult and often rely on detailed cognitive assessments to help them. Patients with mild cognitive impairment also differ significantly in terms of future clinical outcomes.

Patients with mild cognitive impairment are at increased risk of worsening symptoms leading to a diagnosis of dementia, but a significant proportion are stable for years without progression of symptoms and some have normal cognition. It may even return to functionality. For example, I took care of several patients diagnosed with mild cognitive impairment suffering from obstructive sleep apnea, a condition that is highly treatable by airway pressure during sleep. Many of them experienced a dramatic reversal of cognitive problems with effective treatment of sleep apnea.

What are the current recommendations for cognitive screening in the elderly? In 2020, the US Preventive Medicine Committee decided that there was no evidence to recommend. For or against cognitive screening Individuals over 65 years old.

“When Memory Fades” is a well-planned consumer aimed at significantly expanding the target population of candidates for Aduhelm, a drug that has yet to show clear clinical efficacy in patients with mild cognitive impairment. It is a marketing campaign for. Disorder or Alzheimer’s disease.

Approval of aducanumab based on its effect on surrogate endpoints (decreased levels of cerebral amyloid) rather than overt improvement in memory and cognition is marketing to people with mild symptoms and no impairment in daily functioning Tested for elevated levels of brain amyloid that may further facilitate the strategy. These individuals are particularly vulnerable to predatory advertising that motivates them to look for amyloid-lowering drugs such as aducanumab, as 25% to 40% of people between the ages of 50 and 65 are positive for amyloid in the brain. .. It costs $ 56,000 a year. — And stay in the false hope that it may prevent Alzheimer’s disease.

I’m worried about unchecked ads like the “When Memory Fades” campaign. Clinicians like me need to make sincere and collaborative efforts to counter this false information and educate patients. We must ensure that their despair is not monetized and that their hopes are not held hostage for the benefit.

As the surgeon general eloquently states, “Restricting the dissemination of false information about health is a moral and civil obligation that requires the efforts of society as a whole.”

Madhav Thambisetty is an adjunct professor of neurology at Johns Hopkins University School of Medicine. The views expressed here are his own and do not necessarily reflect the views of Johns Hopkins University School of Medicine.



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