Cross-cultural communication （131）　

131) Advances in Alzheimer's Disease Treatment Drugs
The January 5, 2023, issue of the New England Journal of Medicine (NEJM) featured an article titled “Lecanemab in Early Alzheimer's Disease.” Lecanemab, developed by Eisai Pharmaceuticals, is a groundbreaking drug that reduces amyloid beta, believed to be a cause of Alzheimer's disease (hereinafter referred to as dementia). It has garnered global attention from countries grappling with an aging population and the resulting increase in dementia. Following the NEJM announcement, approval was granted in the United States and Japan in January, and approval in Europe, starting with France, is reportedly imminent.

Eisai, the company that developed Lecanemab, has been actively involved in the development of dementia drugs for over 40 years. Donepezil (brand name Aricept), developed in the 1980s, also garnered global attention and remained Eisai's flagship product for over a decade until its patent expired. Even during its clinical trial phase, there were reports that former President Reagan, who had developed dementia, took the drug at the strong request of his wife Nancy. However, while Donepezil was marketed as enhancing the activity of the neurotransmitter serotonin to produce its effects, it was not a causal therapy. Additionally, among the physicians who used it, it was not considered to be effective enough to be noticeable.

Under the leadership of Haruo Naito, the grandson of the company's founder, Eisai continued its research and development of dementia drugs aimed at addressing the underlying causes of the disease, even after the development of donepezil, and finally arrived at Lecanemab. However, for a groundbreaking new drug like Lecanemab, the real test begins once it receives approval from regulatory authorities in various countries and is actually put into use. While efficacy is a key concern, if significant side effects emerge, the drug will be deemed ineffective. Among the potential side effects currently under scrutiny, bleeding, particularly cerebral hemorrhage, is the most concerning.

If Lecanemab is adopted worldwide in the near future, demonstrates reasonable efficacy, and does not result in serious side effects, the potential benefits could be astronomical. The January 5 issue of the New England Journal of Medicine was likely read not only by medical professionals but also by securities analysts worldwide who understand English. Interestingly, for over a decade, the second-largest group of NEJM readers after physicians has been securities firm employees. In today's world, pharmaceutical companies cannot sustain themselves without global sales. Without profits, there is no funding for research and development. Therefore, the notion that “red beard (an ideal doctor who treats poor and sick people kindly without asking for money in the novel by Shugoro Yamamoto.) ” is completely irrelevant in the pharmaceutical industry.

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