Been digging into #aducanumab data, thinking about how to advise my patients & their caregivers when they ask me, keeping in mind shared decision-making and that these are individual decisions. Would be grateful for feedback/corrections: 1/7
“Some colleagues I respect say they won’t prescribe this drug. I haven’t made that decision, but as of now I don’t recommend it to anyone. I do want you to make the choice that is right for you, so if you still want to try after we talk then we can discuss how to do that.” 2/7
“When @US_FDA considers approving a drug, they ask a panel of outside experts for recommendations. In this case, none of the 11 experts thought the company has shown that the drug works. It was very strange for FDA to approve the drug despite such strong criticism.” 3/7
“The company $BIIB did 2 studies that weren’t consistent. In one, the drug seemed to work and in the other it seemed not to. But even in the 'good' study the benefit was small—less than half a point on an 18 point scale. This is less than the drug you’re already taking.” 4/7
“Meanwhile, over 1/3 of patients who got the full dose drug developed swelling or bleeding in their brains. Most times this was just something caught on scans, but 1 in 10 patients with this dose had symptoms like headache, confusion, vision changes, nausea and vomiting.” 5/7
“Usually the brain swelling would go away after they paused the drug for a while. But out of every 14 patients who were supposed to get the full dose, 1 had to be permanently taken out of the study because of brain swelling or bleeding.” 6/7
“Some people really want this drug to work, hoping it will lead to better treatments in the future. But that’s not itself a reason for you to take it now. Can I answer any other Qs about this drug, or how we’ll be using it in this clinic, or other ways to protect your brain?” 7/7

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