Older Americans’ interest in Aduhelm limited despite publicity, FDA approval

Publicity surrounding FDA approval of Aduhelm for Alzheimer’s disease did not contribute to understanding of nor enthusiasm for the drug among middle-aged and older adults, according to survey results published in JAMA Network Open.

“Informed use decisions should weigh potential benefits and harms associated with the drug, which presumes that individuals understand these issues,” Julie Zissimopoulos, PhD, of the Sol Price School of Public Policy at the University of Southern California, and colleagues wrote.

Researchers sought to ascertain whether publicity surrounding FDA approval of Aduhelm (aducanumab, Biogen/Eisai) influenced the attitudes or knowledge of older Americans.

Zissimopoulos and colleagues collected data from 1,035 individuals, aged 55 years and older, in the Understanding America Study via an online survey conducted between July and August 2021. They measured self-assessed knowledge about aducanumab, as well as the number of correct responses to six questions about the drug, using scales of agreement to understand attitudes toward outcomes associated with aducanumab. Using logit regression models, researchers estimated associations based on a range of socioeconomic indicators, with odds of seeking cognitive screening after drug approval and demand for aducanumab if diagnosed with AD as outcomes. They analyzed data from August through September 2021.

Results showed that despite concern about AD among 878 of 1,035 individuals who saw and responded to the question, 277 reported some or fair amount of knowledge of aducanumab. Among 1,030 respondents, 451 individuals agreed that aducanumab would provide a societal benefit, and approximately half of participants (n = 504) were concerned about costs to individuals and Medicare (n = 464). Data also revealed that nearly two-thirds (n = 590) of 977 respondents were uncertain about the association of aducanumab with their odds of seeking cognitive impairment screening.

Among 1,033 respondents who saw and answered the question, 240 individuals reported wanting to receive aducanumab if diagnosed with AD. Individuals aged 60 to 75 years were less likely than those aged 55 to 59 to desire treatment with the drug.

“With FDA approval of aducanumab and more drugs in the pipeline, treatment options for Alzheimer’s disease are expanding,” Zissimopoulos and colleagues wrote. “Health care professionals will need to educate patients about potential costs and benefits and to support patients’ decision making.”

In a related editorial, Todd P. Semla, MS, PharmD, of the Feinberg School of Medicine at Northwestern University, noted the survey’s limitations, including the lack of inclusion of persons or families impacted by AD, as well as the brief interval between the drug’s approval in June 2021 and the survey’s initiation in July.

“The survey generates more questions than whether or what efforts are needed to increase the public’s knowledge about aducanumab,” Semla wrote. “The survey findings suggest that there are self-reported knowledge deficits among middle age and older adults about aducanumab and perhaps Alzheimer’s disease.”.