WASHINGTON (AP) — U.S. officials have approved another Alzheimer’s drug that can modestly slow the disease, providing a new option for patients in the early stages of the incurable, memory-destroying ailment.

The Food and Drug Administration approved Eli Lilly’s Kisunla on Tuesday for mild or early cases of dementia caused by Alzheimer’s. It’s only the second drug that’s been convincingly shown to delay cognitive decline in patients, following last year’s approval of a similar drug from Japanese drugmaker Eisai.

The delay seen with both drugs amounts to a matter of months — about seven months, in the case of Lilly’s drug. Patients and their families will have to weigh that benefit against the downsides, including regular IV infusions and potentially dangerous side effects like brain swelling.

Physicians who treat Alzheimer’s say the approval is an important step after decades of failed experimental treatments.

“I’m thrilled to have different options to help my patients,” said Dr. Suzanne Schindler, a neurologist at Washington University in St. Louis. “It’s been difficult as a dementia specialist — I diagnose my patients with Alzheimer’s and then every year I see them get worse and they progress until they die.”

Both Kisunla and the Japanese drug, Leqembi, are laboratory-made antibodies, administered by IV, that target one contributor to Alzheimer’s — sticky amyloid plaque buildup in the brain. Questions remain about which patients should get the drugs and how long they might benefit.

The new drug’s approval was expected after an outside panel of FDA advisors unanimously voted in favor of its benefits at a public meeting last month. That endorsement came despite several questions from FDA reviewers about how Lilly studied the drug, including allowing patients to discontinue treatment after their plaque reached very low levels.

Costs will vary by patient, based on how long they take the drug, Lilly said. The company also said a year’s worth of therapy would cost $32,000 — higher than the $26,500 price of a year’s worth of Leqembi.

The FDA’s prescribing information tells doctors they can consider stopping the drug after confirming via brain scans that patients have minimal plaque.

More than 6 million Americans have Alzheimer’s. Only those with early or mild disease will be eligible for the new drug, and an even smaller subset are likely to undergo the multi-step process needed to get a prescription.

The FDA approved Kisunla, known chemically as donanemab, based on results from an 18-month study in which patients given getting the treatment declined about 22% more slowly in terms of memory and cognitive ability than those who received a dummy infusion.

The main safety issue was brain swelling and bleeding, a problem common to all plaque-targeting drugs. The rates reported in Lilly’s study — including 20% of patients with microbleeds — were slightly higher than those reported with competitor Leqembi. However, the two drugs were tested in slightly different types of patients, which experts say makes it difficult to compare the drugs’ safety.

Kisunla is infused once a month compared to Leqembi’s twice-a-month regimen, which could make things easier for caregivers who bring their loved ones to a hospital or clinic for treatment.

“Certainly getting an infusion once a month is more appealing than getting it every two weeks,” Schindler said.

Lilly’s drug has another potential advantage: Patients can stop taking it if they respond well.

In the company’s study, patients were taken off Kisunla once their brain plaque reached nearly undetectable levels. Almost half of patients reached that point within a year. Discontinuing the drug could reduce the costs and safety risks of long-term use. It’s not yet clear how soon patients might need to resume infusions.

Logistical hurdles, spotty insurance coverage and financial concerns have all slowed the rollout of competitor Leqembi, which Eisai co-markets with U.S. partner Biogen. Many smaller hospitals and health systems aren’t yet setup to prescribe the new plaque-targeting Alzheimer’s drugs.

First, doctors need to confirm that patients with dementia have the brain plaque targeted by the new drugs. Then they need to find a drug infusion center where patients can receive therapy. Meanwhile, nurses and other staff must be trained to perform repeated scans to check for brain swelling or bleeding.

“Those are all things a physician has to have set up,” said Dr. Mark Mintun, who heads Lilly’s neuroscience division. “Until they get used to them, a patient who comes into their office will not be offered this therapy.”

MINNEAPOLIS (AP) — They all had a reason to come back. Every single one of them.

Simone Biles to move past those wrenching two weeks in Japan three years ago, when the gymnastics superstar prioritized her mental health and safety over glory, a decision that inspired some and maddened others.

Suni Lee to prove — perhaps to herself most of all — that the all-around gold medal she earned while Biles watched from the stands wasn’t a fluke.

Jordan Chiles to turn the team silver she helped secure at the 2020 Games into gold.

Jade Carey to be an official member of the five-woman Olympic squad after earning her way to Tokyo as an individual qualifier, a pathway not available to the U.S. this time around and frankly, one she had no interest in exploring again anyway.

They’re all stepping back into the unique spotlight — oh, and 16-year-old newcomer Hezly Rivera, too — only the sport’s biggest stage can provide.

Their reasons are deeply personal. Their motivation, however, is not.

“This is definitely our redemption tour,” Biles said after sewing up a third trip to the Olympics by winning the U.S. trials on Sunday night. “I feel like we all have more to give.”

Perhaps no one more than Biles, who at 27 is the oldest American woman to make an Olympic gymnastics team since the 1950s. She never expected to still be doing this nearly a decade after becoming a crossover sensation at the 2016 Games in Rio de Janeiro.

And here she is. Still working. Still pushing. Not to shut up the critics who still flood her mentions on social media wondering if she’ll “quit” again, but because she remains determined to extract everything she can out of her remarkable talent.

“Nobody’s forcing me to do it,” said Biles, who posted a two-day total of 117.225 to claim the all-around by nearly six points over Lee. “I wake up every day and choose to grind in the gym and come out here and perform for myself. Just to remind myself that I can still do it.”

And do it at a level that no one else in her sport — and when she’s at her best, maybe sports in general — can match.

A trip to France has never really been in doubt since Biles returned from a two-year break last summer. All she’s done over the last 12 months is win a sixth world all-around title and capture her eighth and ninth national championships — both records — while doing the hardest gymnastics of her life.

She will be a prohibitive favorite when she steps onto the Bercy Arena floor though there is plenty to work on before women’s qualifying on July 28. Yet there are things to clean up over the next four weeks.

Biles backpedaled after landing her Yurchenko double pike vault, a testament to both the vault’s difficulty and the immense power she generates during a skill few male gymnasts try and even fewer land as cleanly.

She hopped off the beam after failing to land her side aerial, though she wasn’t quite as frustrated as she was during a sloppy performance on Friday that left her uttering an expletive for all the world to see.

Biles finished with a flourish on floor exercise, her signature event. Though there was a small step out of bounds, there was also the unmatched world-class tumbling that recently drew a shoutout from pop star Taylor Swift, whose song “Ready For It” opens Biles’ routine.

She stepped off the podium to a standing ovation, then sat down atop the steps to take in the moment in what could be her last competitive round on American soil for quite a while. Maybe ever.

Biles sidestepped questions about what lies ahead. That can wait. It’s been a long, winding road back to this moment. She’s intent on trying to enjoy it even while being part of a team that will have “a lot of weight on our shoulders.”

She believes she and her teammates are in a better position to handle it.

“It’s really nice that Tokyo gave us that opportunity to open up that stage for that talk,” Biles said. “And so I think now athletes are a little bit more in tune and we just trust what our gut is saying.”

And Biles’ gut told her that if she wanted to come back, she needed to do it on her terms. That meant taking intentional steps to make sure her life is no longer defined by her gymnastics.

She married Chicago Bears safety Jonathan Owens in the spring of 2023 and the two are building a house in the northern Houston suburbs they hope to move into shortly after Biles returns from Paris.

Biles heads to France as perhaps the face of the U.S. Olympic movement, though she’s well aware that more than a few of the millions that will tune in to watch next month will be checking to see if the demons that derailed her in Tokyo resurface.

And while there are still moments of anxiety — including at last year’s world championships — she has put safeguards in place to protect herself. She meets with a therapist weekly, even during competition season, something she didn’t do in preparation for the 2020 Games.

The Americans will take their oldest women’s team ever to the Games, as Biles’ unrivaled longevity — she hasn’t lost a meet she’s started and finished since 2013 — and the easing of rules around name, image and likeness rules at the NCAA level allowed Carey (24), Chiles (23) and Lee (21) to continue to compete while cashing in on their newfound fame at the same time.

They have relied on that experience during a sometimes harrowing meet that saw leading contenders Shilese Jones, Skye Blakely and Kayla DiCello exit with leg injuries that took them out of the mix weeks before the potential realization of a lifelong dream.

Watching good friends leave the arena in tears offered a reminder of how thin the line between making it and not making it can be. Biles has been on the right side of that line longer than she ever anticipated. She’s going to try and enjoy it, pressure and all.

She may have gotten ahead of herself in 2021. She’s intent on not letting that happen this time around.

“I feel like success is just what I make it,” she said. “I feel like right now I’ve been successful of competing at Olympic trials and making the Paris Olympic team. So then we’ll see from there on out.”