4.5 Review

Is Aducanumab for LMICs? Promises and Challenges

Journal

BRAIN SCIENCES
Volume 11, Issue 11, Pages -

Publisher

MDPI
DOI: 10.3390/brainsci11111547

Keywords

Alzheimer's disease; aducanumab; LMICs; APOE; burden of disease; treatment cost

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Funding

  1. Ministry of Higher Education, Fundamental Research Grant Scheme [FRGS/1/2020/SKK0/MUSM/02/6]

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Aducanumab, as the first disease-modifying treatment for Alzheimer's disease, faces challenges in terms of its applicability and cost-effectiveness in low- and middle-income countries.
Aducanumab, a human monoclonal antibody, was approved in June of 2021 as the first disease-modifying treatment for Alzheimer's disease by the United States Food and Drug Administration (U.S. FDA). A substantial proportion of patients with Alzheimer's disease live in low- and middle-income countries (LMICs), and the debilitating effects of this disease exerts burdens on patients and caregivers in addition to the significant economic strains many nations bear. While the advantages of a disease-modifying therapy are clear in delaying the progression of disease to improve patient outcomes, aducanumab's approval by the U.S. FDA was met with controversy for a plethora of reasons. This paper will provide precursory insights into aducanumab's role, appropriateness, and cost-effectiveness in low- and middle-income countries. We extend some of the controversies associated with aducanumab, including the contradicting evidence from the two trials (EMERGE and ENGAGE) and the resources required to deliver the treatment safely and effectively to patients, among other key considerations.

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