The first new treatment for Alzheimer’s disease for nearly 20 years has been approved by regulators in the United States, paving the way for its use in the UK.
Aducanumab targets the underlying cause of Alzheimer’s, the most common form of dementia, rather than its symptoms.
Charities have welcomed the news of a new therapy for the condition.
But scientists are divided over its potential impact because of uncertainty over the trial results.
At least 100,000 people in the UK with a mild form of the disease could be suitable for the drug if it were to be approved by the UK regulator.
The US Food and Drug Administration (FDA) said there was “substantial evidence that aducanumab reduces amyloid beta plaques in the brain” and that this “is reasonably likely to predict important benefits to patients”.
Controversial trial
In March 2019, late-stage international trials of aducanumab, involving about 3,000 patients, were halted when analysis showed the drug, given as a monthly infusion, was not better at slowing the deterioration of memory and thinking problems than a dummy drug.
But later that year, the US manufacturer Biogen analysed more data and concluded the drug did work, as long as it was given in higher doses. The company also said it significantly slowed cognitive decline.
Aducanumab targets amyloid, a protein that forms abnormal clumps in the brains of people with Alzheimer’s that can damage cells and trigger dementia, including:
- memory and thinking problems
- communication issues
- confusion
‘Heading in right direction’
Aldo Ceresa, who took part in the trial, first noticed problems differentiating between left and right 10 years ago.
After his diagnosis, the 68-year-old, who is originally from Glasgow and now lives in Oxfordshire, close to his family, had to give up his job as a surgeon.
Mr Ceresa took aducanumab for two years before the trial was halted – and then had to wait almost as long for another trial, at the National Hospital for Neurology and Neurosurgery, in London, to begin.
“I’m quite happy to volunteer,” he says.
“I really, really enjoy this journey that I’m going through – and obviously the benefits I’m getting from it, which I’m very, very grateful for.”
He is convinced the drug has helped him.
“I feel like I’m not quite as confused. Although it’s still there, it’s not quite as bad.
“And I’m just getting that bit more confident now.”
Mr Ceresa says his family has noticed improvements too.
“Before, if I was going to get something, I couldn’t remember, you know, where to find things in the kitchen.
“That has become less of a problem,” he says.
“I haven’t caught up to the level that I was before – but I’m heading in the right direction.”
More than 30 million people around the world are thought to have Alzheimer’s, with most aged over 65.
For around 500,000 people affected in the UK, those eligible for aducanumab will be mostly in their 60s or 70s and at an early stage of the disease.
‘Very cautious celebration’
Analysis
We need to keep our feet on the ground.
This is not a miracle drug, nor a cure for Alzheimer’s but it is the first treatment which tackles the destructive mechanism in the brain that drives the destruction of neurons.
And that makes this a landmark moment.
But scientific opinion both here and the United States is divided. While some have welcomed approval, calling it a milestone for millions living with Alzheimer’s, others believe the drug will only have marginal benefits.
Alzheimer’s charities say they will be pressing for an early decision in the UK – but that could take another year.
Lastly, we don’t know how much aducanumab will cost – it could be tens of thousands of pounds per patient each year. And if approved, access will be limited to those who’ve had specialist brain scans to confirm their diagnosis.
Despite all the caveats, this is moment for very cautious celebration.
Prof Bart De Strooper, director of the UK Dementia Research Institute, said the decision to approve aducanumab marked “a hugely significant milestone” in the search for treatments for Alzheimer’s disease.
In the past decade, more than 100 potential Alzheimer’s treatments have flopped.
But while he hoped it would prove a turning point for millions of people with the condition, he said there were “still many barriers to overcome”.
Prof John Hardy, professor of neuroscience at University College London, said: “We have to be clear that, at best, this is a drug with marginal benefit which will help only very carefully selected patients.”
‘Grave error’
And Prof Robert Howard, professor of old age psychiatry at UCL, went further calling the drug’s approval “a grave error” that could derail the ongoing search for meaningful dementia treatments “for a decade”.
He said the FDA had ignored data from the trial which showed no slowing of decline in cognition or function.
Another charity, Alzheimer’s Research UK, said it had written to the Health Secretary Matt Hancock asking the government to prioritise the fast-track approval process for the drug in the UK.
Chief executive Hilary Evans, said: “People with dementia and their families have been waiting far too long for life-changing new treatments.
“It is now essential that regulatory authorities assess the evidence to decide whether they believe the drug is safe and effective for use in the UK.”
Although many doctors are doubtful of aducanumab’s benefits, its US approval could be a huge boost to dementia research, which is traditionally underfunded compared with cancer or heart disease.
Dozens of Palestinians killed in overnight Israeli strikes in central and south Gaza as Red Sea tensions rise.
Here’s how things stand on Monday, January 15, 2024:
Latest updates and human impact
- Israeli attacks continue unabated overnight killing and wounding dozens of civilians in central and southern Gaza. At least 22 people were killed and a large number injured as a result of Israeli forces targeting al-Thalatheni Street in the central Gaza Strip.
- Yemen’s Houthi rebels fired an antiship cruise missile toward an American destroyer in the Red Sea, which was shot down by a US fighter jet, announced US Central Command (CENTCOM) on X.
- This was the first US-acknowledged Houthi attack since the US strikes on Yemen on Friday.
- Hamas released a 37-second video showing three Israeli captives held in Gaza on Sunday, saying they would reveal the fate of the captives on Monday and urging the Israeli government to stop the offensive.
- The Israeli military says it has shifted to a new phase of the war focused on the southern end of Gaza, where almost 2 million internally displaced Palestinians are running out of safe spaces to shelter.
- The Gaza Ministry of Health has said almost 24,000 people have been killed in the Israeli offensive. More than 60,000 people have been wounded in 100 days of war.
Diplomacy
- Israeli Prime Minister Benjamin Netanyahu said on Sunday that his country will pursue its war against Hamas until victory and will not be stopped by anyone, including the International Court of Justice (ICJ).
- The White House said on Sunday that “it’s the right time” for Israel to scale back its military offensive in the Gaza Strip.
- Egypt’s State Information Service (SIS) said in a statement on Sunday that one of the biggest obstacles to the timely delivery of sufficient aid to Gaza was Israeli inspection of the aid. The statement came after Israel blamed Cairo for the delay in aid delivery to Gaza during its defence at the ICJ.
- US Secretary of State Antony Blinken posted on X on Monday, calling for the release of the remaining captives held in Gaza on the 100th day since they were taken by Hamas. He did not mention the Palestinian casualties.
- Australia’s Foreign Minister Penny Wong, who described herself as a “friend of Israel” to the press, will travel to Jordan, Israel, the occupied Palestinian Territories and the United Arab Emirates this week, her office said on Monday.
West Bank raids and violence
- Israeli forces arrested 25 students staging a sit-in in protest against high tuition fees at An-Najah University in Nablus. Al Jazeera’s Hamdah Salhut reported that the protesting students received a text message from Israeli forces telling them to “surrender now”.
- Israeli forces have reportedly raided the family home of Nael al-Barghouti, the longest-serving Palestinian prisoner, in the village of Kobar, in Ramallah, in the occupied West Bank.
- The Israeli army said on Friday that it killed three Palestinian men who infiltrated a West Bank settlement and fired upon soldiers.
- The Israeli military killed two Palestinians after accusing them of ramming their car through a checkpoint near Hebron.
- Local sources reported that Israeli forces bulldozed two Palestinian-owned houses during a Sunday midnight raid in the city of Qalqilya, Palestinian news agency Wafa reported.
- Armed Israeli settlers broke into the village of Burin, south of Nablus, and attacked Palestinian residents’ houses and properties after midnight on Sunday, Wafa reported.
- “Violent raids and arrests have become part of the fabric of daily life in the occupied West Bank,” Al Jazeera’s Mohammed Jamjoom, reporting from Ramallah in the occupied West Bank, said. At least 347 Palestinians have been killed and thousands have been arrested since October 7.
Flames and smoke billow during Israeli attacks against Gaza on October 9, 2023
Human Rights Watch terms Israeli Defence Minister Yoav Gallant’s call for a ‘complete siege’ on Gaza a ‘war crime’.
The Hamas movement has threatened to kill an Israeli hostage every time Israel bombs a Palestinian home without warning as Israel mobilised some 300,000 reservists and imposed a total blockade of the Gaza Strip, denying the enclave’s millions of residents access to food, water and fuel.
The warning from Hamas came on Monday as the death toll from the armed group’s surprise weekend attack climbed to 900 in Israel and revenge attacks by Israeli forces on the besieged Gaza Strip killed more than 700 people and left some 3,700 others wounded.
Residential apartment blocks, hospitals, schools and a mosque have been among the sites attacked by Israeli fighter jets, artillery and drones, according to media reports and witnesses.
Hamas spokesperson Abu Ubaida issued the threat to kill Israelis from the dozens held captive by the armed group. He said an Israeli hostage would be killed for every Israeli bombing of a civilian house without warning.
Israeli Foreign Minister Eli Cohen said more than 100 people were taken captive by Hamas during the deadly cross-border incursion over the weekend.
As Israeli forces conducted intense retaliatory attacks on Gaza on Monday, Israel’s Defence Minister Yoav Gallant drew international condemnation by announcing a total blockade of the densely populated and besieged enclave, which is home to 2.3 million people.
Gallant said Israel would impose a “complete siege” on Gaza. “No electricity, no food, no water, no gas – it’s all closed.”
United Nations Secretary-General Antonio Guterres said he was “deeply distressed” by the siege announcement and warned that Gaza’s already dire humanitarian situation will now “only deteriorate exponentially”.
Guterres also said some 137,000 people were taking shelter with the UN Relief and Works Agency for Palestinian Refugees (UNRWA) at schools across Gaza.
UNRWA said on Tuesday that almost 190,000 people have been displaced in Gaza amid the Israeli attacks and the figure is expected to grow further as the violence intensifies.
Nearly half a million people have also not received food rations this week in Gaza as UN food distribution centres have been forced to remain closed amid the Israeli onslaught, UNRWA said.
Human Rights Watch said Israel’s total blockade on the necessities of life for everyday people in Gaza was a war crime.
“Defense Minister Gallant’s statements are abhorrent,” Omar Shakir, Israel and Palestine director at Human Rights Watch, said in a statement.
“Depriving the population in an occupied territory of food and electricity is collective punishment, which is a war crime, as is using starvation as a weapon of war. The International Criminal Court should take note of this call to commit a war crime,” he said.
Abhorrent. This is a call to commit a war crime by @yoavgallant. The @IntlCrimCourt should take note.
Quote by @OmarSShakir ⤵️ https://t.co/kKVo6YtpI1 pic.twitter.com/neHQMwnXVn
— Human Rights Watch (@hrw) October 9, 2023
Shakir also condemned the threat by Hamas to kill hostages, warning that such action was also a war crime.
“All hostages should be safely released to their families,” he said.
Grotesque. These threatened acts would amount to flagrant war crimes by Hamas’ armed wing. The @IntlCrimCourt will be watching.
Quote from @OmarSShakir ⤵️ https://t.co/FuNtvHe0YG pic.twitter.com/6cnHODLWyZ
— Human Rights Watch (@hrw) October 9, 2023
On the diplomatic front, Egyptian President Abdel Fattah el-Sisi and his Turkish counterpart Recep Tayyip Erdogan called on Hamas and Israel to immediately end violence and protect civilians, the Egyptian presidency said.
Erdogan urged Israel against “indiscriminately” attacking civilians and delivered measured criticism of Hamas, urging both sides to respect the “ethics” of war.
The United Kingdom, French, German, Italian and US governments issued a joint statement on Monday recognising the “legitimate aspirations” of the Palestinian people and supporting equal measures of justice and freedom for Israelis and Palestinians alike.
But the prospect that fighting could spread also alarmed the region and the world.
Lebanese armed group Hezbollah fired rockets into northern Israel in response to at least three of its members being killed in Israeli shelling of Lebanon.
Israel said one of its deputy commanders was also killed in an earlier cross-border raid from Lebanon.
US President Joe Biden holds a bilateral meeting with Israeli Prime Minister Benjamin Netanyahu on the sidelines of the 78th United Nations General Assembly in New York City, the US, September 20, 2023
Social media users, including journalists and observers, are calling out what they call a ‘double standard’.
After Saturday’s surprise attack by the Palestinian group Hamas on Israel, Ukrainian President Volodymyr Zelenskyy took to the social media platform X to offer “condolences go out to everyone who lost relatives or close ones in the terrorist attack”.
He also stated, “Israel’s right to self-defence is unquestionable.”
Many world leaders, including US President Joe Biden and UK Prime Minister Rishi Sunak, shared similar sentiments.
The world is seeing appalling images.
Thousands of rockets raining down on Israeli cities. Hamas terrorists killing not only Israeli soldiers, but civilians on the streets and in their homes.
It’s unconscionable. Israel has a right to defend itself – full stop.
— President Biden (@POTUS) October 7, 2023
European Commission President Ursula von der Leyen stated, “Israel has the right to defend itself – today and in the days to come. The European Union stands with Israel.”
Accusations of Western ‘double standards’
Some social media users have criticised these statements, saying they highlight a double standard.
The world is seeing appalling images.
Thousands of rockets raining down on Israeli cities. Hamas terrorists killing not only Israeli soldiers, but civilians on the streets and in their homes.
It’s unconscionable. Israel has a right to defend itself – full stop.
— President Biden (@POTUS) October 7, 2023
Ukraine’s right to defend itself is praised by most international leaders while Russia’s invasion is condemned, but commentators said the same cannot be said about Israel’s occupation of the West Bank and Gaza.
Aaron Bastani, a leftist British journalist, said on X that there’s a “clear double standard in endorsing terrorism against civilian targets in Ukraine … and condemning it by Palestinians”.
Many users said Western diplomats and media support the Ukrainians who defend their land, but label the Palestinians fighting against Israel as “terrorists”.
https://twitter.com/KhaledBeydoun/status/1710787817415082349?ref_src=twsrc%5Etfw%7Ctwcamp%5Etweetembed%7Ctwterm%5E1710787817415082349%7Ctwgr%5E6acf829869e993177f32aa38aa48c02f38cb7f61%7Ctwcon%5Es1_&ref_url=https%3A%2F%2Fwww.aljazeera.com%2Fnews%2F2023%2F10%2F9%2Fwestern-leaders-accused-of-hypocrisy-over-response-to-palestine-ukraine
An illustration of a woman’s face, in which one eye is closed beside a Palestinian flag, and one eye open beside a Ukrainian flag, has been regularly shared as a symbol of the West’s alleged double standards in how the two conflicts are viewed.
https://twitter.com/OnlinePalEng/status/1710994682883273172?ref_src=twsrc%5Etfw%7Ctwcamp%5Etweetembed%7Ctwterm%5E1710994682883273172%7Ctwgr%5E6acf829869e993177f32aa38aa48c02f38cb7f61%7Ctwcon%5Es1_&ref_url=https%3A%2F%2Fwww.aljazeera.com%2Fnews%2F2023%2F10%2F9%2Fwestern-leaders-accused-of-hypocrisy-over-response-to-palestine-ukraine
Clips also emerged on social media from a CNN interview with Mustafa Barghouti, the general secretary of the Palestinian National Initiative, in which he posed the rhetorical question, “Why does the United States support Ukraine in fighting occupation – while here they support the occupier, who continues to occupy us?”
The hypocrisy and double standards of western governments and media platforms dealing with situations in Ukraine-Russia and Palestine-Israel blow the mind. Absolute disgrace.
— Said Yacoubi (@AlyacoubiSaid) October 8, 2023
It is not the first time Western nations have been accused of double standards in their stance on the Ukraine war.
Earlier in the year, Amnesty International published a report highlighting the West’s “double standards” on global human rights.
Agnes Callamard, Amnesty’s secretary-general, told Al Jazeera at the time that the occupation of Palestinian territory was a “particularly important one”.
“Without making any comparison between Russia’s aggression and Israel … it is clear the Palestinian people are under a regime of oppression – a regime of occupation and a regime of apartheid,” Callamard told Al Jazeera.
Over the last three days, X users recirculated earlier statements calling out what they called Western hypocrisy, sharing video by the Irish lawmaker Richard Boyd Barrett from March 2022 in which he berated the Irish government’s double standards regarding Ukraine and Palestine:
“You’re happy to use the most strong and robust language to describe the crimes against humanity of [Russian President] Vladimir Putin, but you will not use the same strength of language when it comes to describing Israel’s treatment of the Palestinians.”
Barrett on Sunday again called out what he described as “shocking double standards of Western leaders supporting Ukraine resistance but condemning Palestinian[s].”
Meanwhile, others warned against comparing conflicts.
https://twitter.com/denfordauthor/status/1710993737738768607?ref_src=twsrc%5Etfw%7Ctwcamp%5Etweetembed%7Ctwterm%5E1710993737738768607%7Ctwgr%5E6acf829869e993177f32aa38aa48c02f38cb7f61%7Ctwcon%5Es1_&ref_url=https%3A%2F%2Fwww.aljazeera.com%2Fnews%2F2023%2F10%2F9%2Fwestern-leaders-accused-of-hypocrisy-over-response-to-palestine-ukraine
And some cautioned that Hamas and the Palestinians should not be seen as one and the same.
Just to clarify:
Palestine did not mount an attack on Israel. An Iranian proxy militia did. Palestinians are by and large huddled in their homes praying that an Israeli airstrike won't kill them or theirs. Hamas is the culprit here. This isn't a decentralized grassroots thing.
— Romeo Kokriatski (@VagrantJourno) October 9, 2023
Ukrainian footballer Oleksandr Zinchenko, who plays for Arsenal, posted on Instagram, stating he “stands with Israel”.
Zinchenko has been a vocal supporter of his home country in its ongoing defence against Russia, and he participated in a Game4Ukraine charity match in London earlier this year to raise money for Ukraine.
After online backlash, with some questioning an alleged double standard in his support of Israel, the footballer removed the post and switched his social media account to private.
Several people claimed that Zinchenko’s football club, in not responding to his comments, was guilty of hypocrisy after they had distanced themselves from former player Mesut Ozil’s comments in 2019 over alleged human rights abuses against Uighur Muslims in China.
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