An Army Vet’s 23&Me Test Inspired Him to Join a Clinical Trial. There, He Learned He Had Early Signs of Alzheimer’s


After his mom’s loss of life from Alzheimer’s, retired U.S. Military officer Lou Niles determined to look into his personal danger — and to get entangled in dementia analysis. He discusses his inside expertise within the medical trial with Alzheimer’s anti-amyloid donanemab.

Biogen and Eisai’s monoclonal antibody medicine for Alzheimer’s — Aduhelm (now off the market) and Leqembi (absolutely authorized by the FDA in 2023) — have been the primary two of their form: disease-modifying medicine to gradual Alzheimer’s illness by clearing amyloid plaque within the mind. However information remains to be being gathered on how effectively these medicine work. Whereas they’ve been proven to clear amyloid plaque from the mind, it’s not clear how a lot that strikes the dial for particular person sufferers. In the meantime, extra of this class of drug are within the improvement pipeline. The subsequent that’s anticipated to be up for FDA approval is donanemab, which was confirmed promising ends in late 2023 and is at the moment pending FDA overview

Donanemab isn’t but obtainable to most of the people — however it is obtainable to some sufferers enrolled in its medical trials. Their experiences might assist shed some gentle on what to anticipate from these new MAB medicine. Retired U.S. military officer Lou Nile participated within the donanemab medical trial. Niles served as a fight helicopter pilot in Vietnam and as a firefighter and paramedic in San Diego. When his mom died from Alzheimer’s, he realized he too might be prone to cognitive decline, which led him to do a 23&Me DNA check a decade in the past. His check outcomes revealed that he had one genetic mutation related to the next danger for Alzheimer’s. And when he noticed that there was an Alzheimer’s examine in Orlando, Florida, the place he at the moment lives, Niles determined to take part.

Over the course of the trial, he found that he certainly had cognitive decline and amyloid in his mind. Learn or watch the total Being Affected person Dwell Discuss with video journalist Mark Nui beneath to find out about Niles’ expertise with cognitive decline and with the donanemab trial. 

Being Affected person: How did you even discover the trial to participate in it?

Lou Niles: Nicely, I’ve been looking for a chance to cope with Alzheimer’s, and I had the start phases that a minimum of I assumed I had. I misplaced the flexibility to do math like I used to have the ability to do, and spelling and pronunciation started to fade, and, in fact, some reminiscence points. 

My mom died from Alzheimer’s. So, that is what put me on alert that I in all probability was carrying the gene. I used to be examined each by the K2 lab the place I participated within the examine [and] as I used 23&Me to seek out out a few years in the past. They notified me that I had one mutation of the 2 mutations that put you in danger for Alzheimer’s. 

I got here throughout the examine on social media. I feel it might have been Fb. I can’t recall, as I’m in an Alzheimer’s examine. That occurred to be pretty near me in Orlando, about an hour and a half away. So, I known as them up, and so they examined me for a number of different research related to Alzheimer’s, however I didn’t meet that standards. I did meet the standards to attempt to eradicate amyloid protein from my mind looking for the proper dosage. 

I’m within the examine part attempting to find out the proper dosage, and March shall be my 12 months anniversary, the place the CT scan, the MRI, and blood evaluation will decide whether or not the stuff labored for me or not. There’s a small proportion of individuals, in fact, the place this will likely not work. 

“I’m within the examine part attempting to find out the proper
dosage, and March shall be my 12 months anniversary,
the place the CT scan, the MRI, and blood evaluation
will decide whether or not the stuff labored for me or not.”

Now, this drug doesn’t repair something. It merely stops, hopefully, the development. So, the injury already performed— I’m caught with. That’s the place it stands right now; on the half-year anniversary evaluation, I nonetheless have the amyloid protein, and it was not eradicated sufficient. Now, you don’t get to listen to the small print of the examine as a participant; you simply get generalized data, as a result of a part of it is extremely blind. Even the K2 lab workers don’t get any detailed data of outcomes. 

Being Affected person: How outdated have been you in the beginning of the trial?

Niles: I might have been 76.

Being Affected person: How lengthy had you had cognitive impairment earlier than getting into the trial?

Niles: I might say beginning in my late 60s. I grew to become extra conscious of it. What I realized from my mom’s expertise is she had it for a few years, and no one seen. I seen it one time [when] visiting that the one factor she was consuming was avocado sandwiches. She wouldn’t repair meals anymore. That instructed me there was one thing improper, however even then, I used to be in a state of ignorance. Then she was later identified. 

“What I realized from my mom’s expertise
is she had it for a few years, and no one seen.”

So, my father was having points with pancreatic most cancers throughout this actually critical willpower that my mother had Alzheimer’s, and he died shortly thereafter. This can be a horrible illness. She went to my sister’s home in New Mexico. My sister thought she might handle her. You’ll be able to’t handle it. You’ll be able to’t be a caregiver for any such illness; it turns into extraordinarily burdensome and troublesome. So, she went right into a specialised nursing house that dealt with this illness. That’s the place she was till she was about 68. She handed away.

Being Affected person: What was it prefer to submit for the trial? Was it a troublesome course of to get into the trial?

Niles: No, I’ve just a little little bit of a medical background. I used to be a paramedic firefighter in San Diego, and I additionally grew to become a naturopathic doctor. So, I actually am taken with research, impartial of my state of affairs, and I’m all the time prepared to make use of my physique as an experiment. After I heard concerning the examine, there [were] two motives. One is, if I can contribute to the discovering of an answer, yeah, let me take part. The second factor is possibly they will do one thing and arrest this development. 

The K2 lab that I’m utilizing is filled with exceptional individuals and supportive individuals. Truly, you construct relationships with all people, and also you grow to be pals with all people. It’s like a go to with pals each time I’m going there for my IV, and I discovered it very useful and really supportive. 

By the way in which, whenever you get into these research, you get a number of $100,000 value of research, MRI, CT scans, bloodwork, EKGs, physicals, all this sort of stuff. They discovered a left bundle department block in my coronary heart in one in every of their analyses with an EKG, which I might have by no means found. In addition they discover different issues happening in you in addition to simply this explicit facet of the examine due to all of the medical lab work that goes on. That’s a gorgeous factor.

Being Affected person: Inform us about this explicit medical trial. How typically did it’s a must to go, and the way a lot time did the remedy take?

Niles: It’s damaged down [into] a few phases. The primary part— it was each two weeks. I needed to go in for an IV. That was a short-lived part; then, it went to as soon as a month. Then it’s based mostly on what number of weeks, and I can’t recall the small print on that, however each so many weeks, you get an MRI: mind MRI, practical MRI.  

“It’s like a go to with pals each time I’m going
there for my IV, and I discovered it very
useful and really supportive.”

Then you definitely get on the midway mark, you get the CT scan, the bloodwork, and the MRI, to see if there’s any discount within the amyloid protein in your blood, in your mind. If you happen to fail that exact part, and also you proceed on for the subsequent half a 12 months. 

At that milestone, they haven’t stated it immediately, but when it doesn’t work, my interpretation is that if it hasn’t actually performed that a lot for me, it’s not going to do this a lot for me. It’s been very profitable within the first a number of phases of the trial. 

There are individuals within the examine [who] actually have apparent Alzheimer’s signs, some are extreme. I don’t know their standing, in fact, and I do know that we’ve been instructed time and again, don’t count on miracles with this as a result of it doesn’t repair the mind if the mind has already been broken or the nervous system has been broken. 

That’s what it’s like. It’s actually a pleasing expertise to have these many individuals caring for you. That is significantly vital for individuals [who] don’t have medical healthcare insurance coverage. What a present.

Being Affected person: Did you may have any unwanted side effects?

Niles: None. No unwanted side effects in any respect for me. My understanding [is that] it’s tremendous uncommon for unwanted side effects to start with. I can’t bear in mind if I requested if there [were] any critical unwanted side effects [for] any of the purchasers. In the whole world, it’s [a worldwide] examine, and I used to be the primary one within the examine; by the way in which, there hasn’t been any critical organic injury performed by anyone within the examine. 

There was an individual who handed away, however there was no correlation with the remedy, and also you’ll get that problem since you’re coping with largely aged.

Being Affected person: So, you chatted with different individuals within the examine?

Niles: They’re within the room whenever you’re getting the IV. The IV room has bought like 10 chairs. So, different sufferers will are available; they’ll be sitting subsequent to you and issues like that. 

Being Affected person: What did you hear about their experiences? Had been they similar to yours? Or have been there others that had unwanted side effects?

Niles: What’s actually bizarre about that’s that nobody ever talks about that. I can’t clarify that. We sit there and chit-chat about small stuff however don’t actually go into our particular person circumstances. As a result of every particular person is so totally different and at totally different phases. 

You already know, it’s not that widespread individuals lose their means to do math or spelling early on. That’s a moderately unusual symptom for me, and the clinician stated that’s not widespread as effectively. Reminiscence is often the primary set off. However individuals are all the time suspicious of reminiscence points, as a result of that comes together with getting old. 

The issue I see is individuals wait too lengthy to be curious. You all the time must be curious if one thing bizarre occurs to you. You’ve bought to determine what’s improper. Don’t watch for it to deteriorate to the worst diploma. 

“In truth, my large worry is that if this progresses, and
I attain that stage the place I can’t make
selections for myself.”

In truth, my large worry is that if this progresses, and I attain that stage the place I can’t make selections for myself. That line, I don’t know what I might do. I don’t wish to go to the superior phases of Alzheimer’s. There are different sources I can do, if I’m cognitive sufficient to have the ability to make selections for myself. So, I noticed a way of urgency, and due to that, I by no means needed to get to that line that my mom went over and was misplaced ceaselessly inside herself.

Being Affected person: What do they let you know now within the subsequent step? Will they proceed to observe you, and what are among the follow-up steps?

Nile: There’s a separate examine by someone impartial of the lab that’s doing follow-up after you allow the examine. My understanding is that Lilly itself is not going to be following the individuals’ well being from that time on, though there is a corporation that’s doing that, however I feel it’s impartial. 

By the way in which, I wish to deliver this up too, as a result of some individuals would possibly surprise in the event that they must journey nice distances and stuff to do that, you’re paid. You’re given a stipend for every go to, you’re given mileage, and also you’re given $30 a day you go to for lunch, and that’s allowed me to have some sushi. So, that’s a superb profit for me. 

You’re not going to have actually plenty of out of pocket bills. Now if it’s a must to go to a CT scan or an MRI facility separate from the K2 lab, [it] doesn’t do this. My understanding is you don’t get these advantages. At that time, you’re by yourself.

Being Affected person: It feels like total, it was fairly a pleasing expertise, however you’re undecided whether or not it had any actual impact.

Niles: The one method I’m going to know is once they reveal the CT, MRI, and blood check in March.

Being Affected person: What else do you assume you realized? Particularly, what did you find out about your self throughout this expertise, and what to bear in mind through the improvement of those medicine?

Niles: I’ve a sister who I’ve pleaded with to get right into a examine, however she’s in New Mexico, and I feel Albuquerque can in all probability be the closest place. Some individuals don’t wish to know. I’ve realized by this that it’s a must to be very proactive if you’re in danger for this illness. 

As quickly as my mom bought actually unhealthy off, I modified my life-style to be supportive of my mind and nervous system. How I eat, what I do, train, all this. I used to be attempting to arrest the chance lengthy earlier than there was dialogue about medicines. 

This was happening within the late 80s when my mom was identified. So, in life, [I] made a giant change once I realized that I had one of many genes. My mom was affected, which made me assume I had one of many genes. That’s how proactive it’s a must to be when you actually wish to tangle with this illness, and also you assume you’re going to.  Then there are these, in fact, that simply hope and a prayer and don’t pay any consideration to it. 

“Some individuals don’t wish to know. I’ve
realized by this that it’s a must to be
very proactive if you’re in danger for this illness.”

Simply, “Life’s life, and I’ll find yourself that method. That’s the way in which I’m going to be.” But it surely’s a horrible, horrible expertise, not just for you, as a result of finally you go into the abyss, and also you don’t know who you’re or who anybody is round you. Your loved ones is terrorized by this illness, completely terrorized.

Being Affected person: As you watch for the outcomes of the trial, what are your hopes for the longer term by way of this drug?

Niles: The drug, it has been relayed to me, has been efficient, and I’ve a superb probability to have cleared my physique of the amyloid protein. That’s what I’m relying on. That’s what they’re relying on. I’ll know in March, and that’s my focus. I feel I’m going to stroll out of this factor higher for it.

Being Affected person: What would you say to someone that’s taken with doing a medical trial?

Niles: Any medical trial for any illness, if you will get into it, it’s extraordinarily useful from a medical perspective. Impartial of the particular factor you’re going after, they scrutinize you and analyze you and they’re going to discover every kind of issues that, you turning into conscious of, you’ll be able to attend to and get mounted. 

Fortuitously for me, my coronary heart illness was not that detrimental; it was very benign, truly — which I discover very unusual. I used to be uncovered to Agent Orange in Vietnam, so I’m on a brief record of every kind of ailments, together with most cancers. In my state of affairs, I’m significantly vigilant about my well being total due to that. 

I feel individuals have to have a look at their danger; they’ve to actually take a look at their zip code, the place they reside — it actually counts about their long run well being and longevity. If you happen to reside close to a freeway otherwise you reside close to a petrochemical plant, try to be getting checked on a regular basis, for every kind of issues. That’s the considering I adopted out of worry initially after which curiosity as a result of I’m all the time interested in every little thing in medication. 

I don’t purchase into the conspiracy theories about pharmaceutical corporations. There are researchers and scientists there which can be actually, actually desirous to do good, impartial of the profitability of any type of remedy. This, by the way in which, in all probability shall be an costly drug, and since it may be solely administered by IV, you’ll must go to an IV heart. I don’t know what these prices are, as a result of I’m getting every little thing totally free. 

Katy Koop is a author and theater artist based mostly in Raleigh, NC.