美国国家公共电台 NPR--An experimental Alzheimer's drug could be approved next year. But it comes with risks

An experimental Alzheimer's drug could be approved next year. But it comes with risks

Transcript¹

Researchers say the experimental Alzheimer's drug Lecanemab represents an important advance and is likely to get FDA approval in 2023, despite some safety concerns.

STEVE INSKEEP, HOST:

An experimental drug is raising hope for the treatment of Alzheimer's disease, although it does come with some risks. So NPR's Jon Hamilton looked at the evidence.

JON HAMILTON, BYLINE²: The drug, called lecanemab, only slows down Alzheimer's a bit. But it dominated last week's Clinical Trials on Alzheimer's Disease meeting in San Francisco. Dr. Eric Reiman was there. He's the executive director of Banner Alzheimer's Institute in Phoenix³.

ERIC REIMAN: There was a feeling of elation⁴ that this was a milestone⁵ in the fight against Alzheimer's disease and very important.

HAMILTON: A study of nearly 1,800 people in the early stages of Alzheimer's found that lecanemab slowed down declines in memory and thinking by 27%. Reiman says that's a modest but meaningful benefit from the drug.

REIMAN: It had effects on a range of cognitive⁶ and functional⁷ measurements that are important to families and family caregivers. But clearly, a treatment by itself that is not going to stop the progression of the disease.

HAMILTON: Lecanemab contains antibodies designed to remove a substance called amyloid from the brain. That makes it similar to the controversial drug Aduhelm, which received a conditional⁸ approval from the Food and Drug Administration last year. The agency acted despite conflicting evidence on whether Aduhelm slows down the disease. Reiman says the results with lecanemab are much clearer.

REIMAN: I'll be surprised if it doesn't get full approval.

HAMILTON: Probably sometime next year. Both Aduhelm and lecanemab have risks, including a condition known as ARIA⁹. Dr. Sharon Cohen, medical director of the Toronto Memory Program in Canada, says when a brain scan shows ARIA, it's a sign of either swelling¹⁰ or bleeding.

SHARON COHEN: This sounds very dramatic to have swelling in the brain or bleeding in the brain, and of course, nobody wants that.

HAMILTON: But Cohen says even though ARIA is common, it rarely has a big impact on patients' health.

COHEN: What we've learned over time is that a very small proportion of individuals will have symptoms, and when symptoms arise, they are usually transient, mild to moderate and resolve.

HAMILTON: In rare cases, though, patients can experience brain damage or even death. Cohen says the risks of ARIA appear to be higher in people who have very high levels of amyloid in the brain or are taking blood thinners.

COHEN: There will be patients for whom this is not a good therapy.

HAMILTON: Lecanemab and other drugs that remove amyloid have another side effect that is more mysterious. They seem to cause the brain to shrink. And that concerns Dr. Madhav Thambisetty, a neurologist at the National Institute on Aging, a part of the National Institutes of Health.

MADHAV THAMBISETTY: What is a little worrying to me is that these drugs might be worsening the degenerative process that is associated with disease progression.

HAMILTON: Alzheimer's itself causes the brain to shrink, a sign that neurons are dying. So Thambisetty, whose views are independent of the NIH, expected Alzheimer's drugs to limit shrinkage rather than accelerate it.

THAMBISETTY: It's incumbent¹¹ upon drug developers and researchers to try and prove that these changes are benign¹² and do not represent a significant adverse¹³ event.

HAMILTON: Dr. Reisa Sperling directs the Center for Alzheimer's Research and Treatment at Brigham and Women's Hospital in Boston. She says serious side effects are common in treating other diseases like cancer.

REISA SPERLING: Alzheimer's is a terrible disease, and I think many patients and their physicians will be willing to take some risk. And our work is to minimize the risk.

HAMILTON: About 2 million Alzheimer's patients in the U.S. are potential candidates for lecanemab.

Jon Hamilton, NPR News.

1 transcript   

n.抄本，誊本，副本，肄业证书

参考例句：

• A transcript of the tapes was presented as evidence in court.一份录音带的文字本作为证据被呈交法庭。
• They wouldn't let me have a transcript of the interview.他们拒绝给我一份采访的文字整理稿。

2 byline   

n.署名；v.署名

参考例句：

• His byline was absent as well.他的署名也不见了。
• We wish to thank the author of this article which carries no byline.我们要感谢这篇文章的那位没有署名的作者。

3 phoenix   

n.凤凰，长生(不死)鸟；引申为重生

参考例句：

• The airline rose like a phoenix from the ashes.这家航空公司又起死回生了。
• The phoenix worship of China is fetish worship not totem adoration.中国凤崇拜是灵物崇拜而非图腾崇拜。

4 elation   

n.兴高采烈，洋洋得意

参考例句：

• She showed her elation at having finally achieved her ambition.最终实现了抱负，她显得十分高兴。
• His supporters have reacted to the news with elation.他的支持者听到那条消息后兴高采烈。

5 milestone   

n.里程碑；划时代的事件

参考例句：

• The film proved to be a milestone in the history of cinema.事实证明这部影片是电影史上的一个里程碑。
• I think this is a very important milestone in the relations between our two countries.我认为这是我们两国关系中一个十分重要的里程碑。

6 cognitive   

adj.认知的，认识的，有感知的

参考例句：

• As children grow older,their cognitive processes become sharper.孩子们越长越大，他们的认知过程变得更为敏锐。
• The cognitive psychologist is like the tinker who wants to know how a clock works.认知心理学者倒很像一个需要通晓钟表如何运转的钟表修理匠。

7 functional   

adj.为实用而设计的，具备功能的，起作用的

参考例句：

• The telephone was out of order,but is functional now.电话刚才坏了，但现在可以用了。
• The furniture is not fancy,just functional.这些家具不是摆着好看的，只是为了实用。

8 conditional   

adj.条件的，带有条件的

参考例句：

• My agreement is conditional on your help.你肯帮助我才同意。
• There are two forms of most-favored-nation treatment:conditional and unconditional.最惠国待遇有两种形式:有条件的和无条件的。

9 aria   

n.独唱曲，咏叹调

参考例句：

• This song takes off from a famous aria.这首歌仿效一首著名的咏叹调。
• The opera was marred by an awkward aria.整部歌剧毁在咏叹调部分的不够熟练。

10 swelling   

n.肿胀

参考例句：

• Use ice to reduce the swelling. 用冰敷消肿。
• There is a marked swelling of the lymph nodes. 淋巴结处有明显的肿块。

11 incumbent   

adj.成为责任的，有义务的；现任的，在职的

参考例句：

• He defeated the incumbent governor by a large plurality.他以压倒多数票击败了现任州长。
• It is incumbent upon you to warn them.你有责任警告他们。

12 benign   

adj.善良的，慈祥的；良性的，无危险的

参考例句：

• The benign weather brought North America a bumper crop.温和的气候给北美带来大丰收。
• Martha is a benign old lady.玛莎是个仁慈的老妇人。

13 adverse   

adj.不利的；有害的；敌对的，不友好的

参考例句：

• He is adverse to going abroad.他反对出国。
• The improper use of medicine could lead to severe adverse reactions.用药不当会产生严重的不良反应。