It has been a divisive period in our history, made more acute by scientific misinformation, erosion of trust in leadership as well as in the physician community, and controversies that affect the well-being of our society. So when a new drug is released that is touted to offer help to people with Alzheimer's disease (especially in the aftermath of a pandemic that shut down research for months), it is understandable that it generates so much interest—and hope.
Aducanumab (Aduhelm) was approved by the US Food and Drug Administration (FDA) on June 7, but its approval has spurred some controversy. In our story “New Alzheimer’s Drug Aducanumab Stirs Controversy and Hope,” we explain how the drug works, describe its potential benefits and limitations, and provide unbiased advice based on the expertise of our editorial advisory board, all of whom are members of the American Academy of Neurology (AAN).
As we go to press, three medical centers—the Cleveland Clinic in Ohio, Mount Sinai Health System in New York, and Providence Health in Renton, WA—have just announced they will not prescribe the drug amid safety concerns, including a debate about the drug's effectiveness and whether the FDA lowered its standards in issuing its approval. Many of my colleagues share these apprehensions and strive to answer questions about this treatment with their patients.
We encourage patients to have discussions with their physicians when weighing the risks and benefits of all options—and before cognitive function starts to decline. An ethical guideline just released by the AAN acknowledges that caring for people with dementia requires respecting their autonomy and involving them in the decision-making process as early as possible so their wishes can be known, while acknowledging their diminishing ability to make those decisions.
Another story on new therapies focuses on the compassionate use program, which may offer expanded access to investigational drugs for those who have life-threatening or serious conditions and have no other treatment options. We cover how patients qualify for the program and how to assess the risks and benefits of the drug in the context of their disease. That careful analysis is also applied in our Take Charge story on drugs with black box warnings, many of which are used to treat neurologic conditions. In all three stories, we detail why informed treatment decisions are so important.
We hope you'll be inspired by our cover story on actor Gary Sinise, whose foundation supports veterans and first responders recovering from traumatic brain injury and posttraumatic stress. He describes his unlikely journey from failing high school student to successful actor, and how that motivated him to help those who have served our country.
As always, we feature readers who overcame adversity, among them Jerry Gidner, a Native American with Tourette syndrome who recently joined the board of the Tourette Association of America; Joe Jalkiewicz, who considers himself an “average Joe” even though he was born with two extraordinary conditions, spina bifida and hydrocephalus; and Tiffany Kairos, whose epilepsy diagnosis gave her a new purpose.
We continue to provide coverage of COVID-19 on BrainandLife.org, including a blog on good reasons to continue wearing a mask. That's something I do in public places in solidarity with those who are more vulnerable, including readers with chronic conditions and compromised immune systems. As others have described themselves in our Messages of Hope videos, I am a proud member of the Brain & Life community.
Orly Avitzur, MD, MBA, FAAN, Editor-in-Chief
