Vasileios Lyras MD, MSc

Neurologist | Alzheimer's disease & related dementias | Memory clinic | Long-term care scientific coordinator

[Vasileios Lyras MD, MSc @vlyras]

Interesting Lancet Neurology paper by Mattsson-Carlgren et al. In symptomatic memory-clinic patients, adding plasma eMTBR-tau243 to p-tau217 raised PPV for established AD from 57% to 84%. Promising for blood-based stratification, not a substitute for clinical assessment.

[Michael Okun @MichaelOkun]

Lecanemab and long term Alzheimer’s: are we finally bending the curve? Low baseline tau seems to be important. Amyloid refers to sticky protein clumps in the brain that are believed to contribute to Alzheimer's disease. Christopher van Dyck and colleagues describe in an abstract from this years American Academy of Neurology meeting the most recent findings from the Clarity AD open label extension study examining up to 48 months of treatment w/ lecanemab in early Alzheimer’s disease.
Key points:
- Lecanemab treatment showed continued slowing of cognitive and functional decline through 48 months compared to matched controls.
- Treatment differences increased over time suggesting a possible cumulative or durable disease modifying effect.
- A meaningful proportion of participants showed no decline or even improvement especially in those w/ low baseline tau.
My take: This is important as longitudinal signals in Alzheimer’s disease matter. The idea that treatment effects may grow over time is provocative and raises the possibility that early and sustained intervention could meaningfully alter trajectory. At the same time we must remain cautious as these are open label extension data, and longer term real world validation will also matter.
Here are 5 points that resonated w/ me:
1- Early treatment may be key to maximizing benefit in Alzheimer’s disease.
2- Slowing decline over years rather than months is what folks and families care about most.
3- The subgroup w/ low tau may represent a window where intervention is most effective.
4- Safety signals appear stable over time which is reassuring for ongoing use.
5- The future may include combining amyloid therapies w/ other approaches to further shift the disease course.
https://t.co/iGO61I3kkM @ParkinsonDotOrg #parkinson #alzheimer @alzassociation

[Vasileios Lyras MD, MSc @vlyras]

@AdonisGeorgiadi Καλή Ανάσταση και καλό έργο. Το νομοσχέδιο κινείται θετικά, αλλά για τη νόσο Alzheimer απαιτείται ρητή πρόβλεψη για βιοδείκτες, αναγκαίες εξετάσεις, MRI παρακολούθηση και πιστοποιημένα κέντρα μνήμης, ώστε η καινοτομία να γίνει πραγματική πρόσβαση για τους ασθενείς.

[Vasileios Lyras MD, MSc @vlyras]

@testingcatalog Would love to try this

[Vasileios Lyras MD, MSc @vlyras]

@petergyang Although a total ignorant in coding and clinician as a profession I used VS to create an academic workflow that scans articles of my interest elaborates them with local AI and posts them on daily journal in Logseq Same with pdf I add in Zotero Then AI daily elaborates my notes

[Vasileios Lyras MD, MSc @vlyras]

@smead2 any link to free pdf?

[Vasileios Lyras MD, MSc @vlyras]

@AMrandom12345 @sama @AskPerplexity summarize this

[Vasileios Lyras MD, MSc @vlyras]

One-quarter of unresponsive people with brain injuries are conscious https://t.co/AJgHBRmh8k

[Vasileios Lyras MD, MSc @vlyras]

@Gill_Livingston @ProfRobHoward @NLMHP_nhs prolly he is a P-tau fan as a plasma biomarker like all of us

[Vasileios Lyras MD, MSc @vlyras]

@jasonkarlawish @MadhavThambiset @nvillain_alz @DavidJonesBrain @smead2 @SuzanneESchind1 @DrTFromKC @seb_walsh @pash22 @EWidera @ajlees @ProfRobHoward @MemoryDoc @dr_shibley @LonSchneiderMD @_michael_scholl @VincentPlanche @StefanoSensi14 @AlbertoEspay @KasperKepp @PhilAlz @Gill_Livingston @jfballenger @JamesRuFletcher @AdamMBrickman @ManlyEpic @SFAckley @FortuneMagazine @TIME @ErinMPrater @TimeMagazineRS @FT @hannahkuchler @CTADconference @NIH @alzassociation @howard_gleckman @AmerGeriatrics @kathy_y_liu @r_merrick @nlundebjerg @NathanielChinMD @US_FDA @NICEComms @RaymondKoopmans @MaastrichtU @Kariem_Ezzat @DrBenUnderwood1 @NHSEngland @ObserverUK Blood biomarkers should be assessed only in presence of mild cognitive impairment or early stage dementia,prescribed by specialists and reimbursed accordingly Marketing for lucrative reasons can be avoided or restrained as it happens with MRI and other diagnostic examinations

[Vasileios Lyras MD, MSc @vlyras]

@smead2 @WheelerSimon In my experience as a dementia specialist one of the most efficient drugs is levomepromazine in the lowest possible dosage as it may cause hypotension

[Vasileios Lyras MD, MSc @vlyras]

@mreflow Weekly recap. Period. keep up the great work!

[Ian Kremer @LEAD_Coalition]

#Medicare Will Cover 80% Of #Alzheimers treatment #Leqembi Cost; No Trial Entry Needed https://t.co/2iuxpf3sXd

#dementia #pharmacy #insurance

[Vasileios Lyras MD, MSc @vlyras]

@TheJasSingh Very useful but limited to 60 minutes video.Maybe later on will handle longer videos

[Vasileios Lyras MD, MSc @vlyras]

@AMannanBaig [email protected]. Thank you

[Vasileios Lyras MD, MSc @vlyras]

@fortelabs Now you should connect Readwise to RoamResearch and you are done!

[Vasileios Lyras MD, MSc @vlyras]

@jasonkarlawish Always to the point Thank you

[Vasileios Lyras MD, MSc @vlyras]

@ProfRobHoward MRI evidenced transient hypoxia in hippocampus

[Vasileios Lyras MD, MSc @vlyras]

@RenegadeSynapse @ProfRobHoward MCI isn’t necessarily due to neurodegeneration. It’s diagnosis is useful in order to program a therapeutic plan for reversible causes as well as frequent monitoring in case of neurodegenerative causes.

[Vasileios Lyras MD, MSc @vlyras]

@ProfRobHoward @Suzanne04823062 Very interesting although still waiting data for clinical effect of pimvanserin in AD related psychosis