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Innovative drug therapy to delay the progression of Alzheimer’s disease symptoms was applied for the first time in Latvia at the East Hospital
At the Neurology and Neurosurgery Clinic of the Riga East Clinical University Hospital (East Hospital), a 68-year-old patient underwent treatment with innovative medications that might significantly delay the progression of Alzheimer’s disease. Given that clinical trials have demonstrated the high effectiveness of this medication, it is already being prescribed to patients in the US, Japan, and Europe following a patient evaluation in accordance with strict medical guidelines. Although this medication is not yet publicly funded in Latvia, in view of the successful treatment outcomes, the physicians at the East Hospital will advocate for the compensation of this medication for each patient who would require it. Neurologists at the East Hospital highlight a concerning trend: Alzheimer’s disease is increasingly diagnosed in younger patients.
Each year, more than 1,200 patients with dementia, including Alzheimer’s dementia, receive treatment at East Hospital. At the early stage of the disease, approximately 40 patients would be eligible for and benefit from therapy with specific innovative medications.
The first patient in Latvia to receive the currently most effective medication to delay the progression of Alzheimer’s disease at the East Hospital Neurology and Neurosurgery Clinic is a 68-year-old woman who was diagnosed with Alzheimer’s disease before the age of 65. She was monitored for a prolonged period on an outpatient basis by neurologist and algologist Andrejs Kostiks. As the disease progressed, the patient was transferred to the Neurology and Neurosurgery Clinic of the Gaiļezers Inpatient Facility of the East Hospital for further in-depth examinations. Following the conversation with the family members of the patient, it was decided to initiate treatment with the innovative drug. Active participation of the patient’s family members was the key factor in successful treatment.
The first administration of the medication took place at the Neurology Day Care Department of the East Hospital. The medication is administered every two weeks following an MRI examination and an assessment of the patient’s general health status prior to each administration. A multidisciplinary team is involved in the treatment of the patient.
The attending physician of the patient, the neurologist Zane Anna Litauniece from the East Hospital Neurology and Neurosurgery Clinic, explains: “The effectiveness of this medication has been demonstrated in clinical trials and it is currently considered one of the leading therapies worldwide to preserve cognitive function and delay the rapid progression of Alzheimer’s disease.”
Before deciding to prescribe this medication, the patient was assessed by a neurology case conference and the decision was made strictly according to international medical guidelines. The evaluation of the patient’s health status / Alzheimer’s diagnosis is a complex, highly specific and time-consuming process. The patient undergoes various genetic tests and MRI examinations to rule out any other pathologies. The prescription criteria for this medication are strictly defined in international guidelines and the manufacturer’s protocol. This specific therapy has been shown to be the most effective in patients with mild to moderate cognitive disorders. However, a series of prerequisites and medical contraindications must be taken into account.
At present, this effective medication is neither listed as copay medication nor publicly funded in Latvia. According to neurologists and neurosurgeons at East Hospital, preliminary estimates suggest that, on average, around 40 patients annually would benefit from this medication to delay the progression of Alzheimer’s disease.
“”While the patient’s family decided and was able to cover the cost of the medication, which amounts to approximately EUR 25,000 per year, we are aware that it is a substantial amount that most patients who would require and benefit from this therapy could not afford. At the same time, it is the physician’s obligation to assess and honestly inform the patient and their family about effective treatment options currently available to patients at the East Hospital,” concludes neurologist Zane Anna Litauniece.
Alzheimer’s disease cannot be cured, but its progression can be delayed. The innovative medication can help maintain the patient’s mental health at a level that allows them to remain self-sufficient. “When a patient is diagnosed with Alzheimer’s disease at the East Hospital Memory Unit, we also talk to the patient’s relatives about the available treatment options and the new reality they will face. It is often difficult for the patient’s family to come to terms with the fact that their loved one or a family member will no longer be the same person they once knew. As the disease progresses, the patient experiences personality changes and memory loss, which can be extremely painful to witness,” explains neurologist Zane Anna Litauniece.
According to the statistics, over 1,200 patients with various cognitive disorders, including those diagnosed with Alzheimer’s disease, receive treatment at the East Hospital each year. Furthermore, neurologists at the East Hospital highlight a concerning trend: Alzheimer’s disease is increasingly diagnosed in younger patients. For instance, at the Memory Unit of the East Hospital, Alzheimer’s disease is often diagnosed in patients aged 50 to 60. However, there are also younger patients diagnosed with this disease.
Neurologist Zane Anna Litauniece mentions several warning signs that should prompt individuals to schedule an appointment at the Memory Unit of the East Hospital. These include forgetting names and surnames, repeatedly forgetting recent actions throughout the day, and being reminded by colleagues or relatives about previously agreed activities or events that the individual does not recall discussing. The first to notice such changes are usually relatives, e.g., in cases where a family member becomes disoriented in a familiar place or when their personality starts to change, which is very common in case of Alzheimer’s disease.
Upon observing those warning signs, neurologist Zane Anna Litauniece encourages the individual to schedule an appointment with the general physician to obtain a referral to specialists in the Memory Unit of East Hospital. Initial tests will allow to determine whether the concentration and memory difficulties may be related to stress, burnout syndrome, or depression, or whether they may indicate early signs of Alzheimer’s disease, requiring further examinations. Early detection of this disease is crucial. In the Memory Unit of East Hospital, the neurosurgeon will inform and advise the patient about various treatment options to delay the progression of Alzheimer’s disease.
The multidisciplinary team involved in the treatment of the particular patient included Professor Guntis Karelis, neurologists Zane Anna Litauniece, Andrejs Kostiks, Rūta Ozoliņa, and Ieva Paegle, interventional radiologist Dr. med. Nauris Zdanovskis, clinical psychologist Dr. psych. Jeļena Harlamova, and psychiatrist Kristīna Buta from the Toxicology and Sepsis Department.
Photo: https://www.flickr.com/photos/austrumu_slimnicas_foto/albums/72177720329497818
About the East Hospital
The Riga East Clinical University Hospital is the largest and strategically significant multi-profile hospital in the country. The hospital consists of five inpatient facilities – Gaiļezers, Latvian Oncology Centre, Biķernieki, Tuberculosis and Lung Disease Centre, and Latvian Infectious Diseases Centre, along with various specialised centres and clinics. The hospital provides highly specialised inpatient and secondary outpatient healthcare, offering multidisciplinary tertiary-level treatment and care in line with modern technology and medical knowledge. Approximately 80% of all cancer patients in Latvia are treated at the hospital. It serves as a practical training base for both Latvian educational institutions and foreign students, providing further education and knowledge transfer to healthcare specialists within and beyond the country. The hospital engages in scientific research and develops innovative methods for patient treatment. As the third-largest employer in the country, the hospital employs around 5000 staff members.
