Lecanemab's Real-world Usage Indicates Infrequent Adverse Effects in Alzheimer's Treatment
The FDA's 2023 green light for medication lecanemab, marketed as Leqembi, brought a glimmer of hope for those battling Alzheimer's disease. While this medicine offers some relief, it could potentially lead to side effects, such as amyloid-related imaging abnormalities (ARIA), which might include brain swelling or bleeding.
First, let's delve into the groundbreaking Clarity AD phase 3 clinical trial published in 2022. This trail demonstrated that only a minuscule percentage of participants, around 0.8%, showed ARIA-E, while 0.7% revealed signs of ARIA-H.
Recent findings from a new study reinforce the Clarity AD trial's conclusions, proving that significant adverse events - like ARIA - are rarely encountered in everyday use of lecanemab for individuals grappling with the earliest phases of Alzheimer's disease.
In this new study, researchers invited 234 participants suffering from early-stage Alzheimer's, with an average age of 74, to be treated with lecanemab at the Washington University Memory Diagnostic Center's outpatient specialty clinic.
"Lecanemab is an antibody, a form of protein produced by your immune system," explains Barbara Joy Snider, MD, PhD, a professor of neurology at WashU Medicine and co-senior author of the study. "These engineered proteins seek specific targets and are designed to combat a range of conditions."
The uptight amyloid proteins make lecanemab's target, explains Snider. These proteins can malfunction and eventually cluster together, impairing brain activity, which is a hallmark of Alzheimer's disease. The amyloid protein misfolding is not the sole cause of the disease, but it may be its initial step, leading to memory loss and dementia.
Snider reports that in a large clinical trial, 18 months of lecanemab treatment led to a 25-30% lower decline in participants' memory and cognitive abilities compared to those not receiving the medication. Brain imaging studies revealed that the lecanemab also reduced and sometimes purged the amyloid plaques in the brain.
The research concluded that 1.8% of participants at the disease's earliest stage reported ARIA symptoms, while 27% of participants with mild Alzheimer's suffered from the same issues. This finding underscores the importance of early diagnosis, as individuals with milder symptoms gain better results from lecanemab (40-50% reduction instead of 25-30%) and experience fewer side effects. Moreover, it is challenging to obtain an accurate diagnosis when symptoms are in their embryonic stages.
Snider's team observed that ARIA symptoms usually vanished within a few months, and no patients lost their life during the study. The team anticipates revealing more about lecanemab's side effects and effectiveness in slowing memory decline. They also look forward to collaborating with other healthcare providers and witnessing bigger studies run by organizations like Alz-Net.
John Dickson, MD, PhD, a neurologist at Massachusetts General Hospital, shared his thoughts on the study, agreeing that lecanemab's side effects are manageable in specialized treatment programs. Further research could identify patients at higher risk of serious ARIA, providing more personalized treatment guidance and enabling patients to make better-informed decisions considering their individual risk profiles.
Lastly, let's discuss lecanemab and donanemab. While lecanemab is currently available to patients, donanemab is undergoing clinical trials. The safer treatment option for each patient depends on their specific risk factors, particularly concerning the risk of ARIA. As research progresses, healthcare providers will have more data available, allowing them to offer their patients the most appropriate treatment choice based on the potential risks and benefits.
- The FDA's approval of lecanemab, marketed as Leqembi, in 2023 brings hope for seniors battling Alzheimer's disease, although it may carry potential side effects like ARIA, including brain swelling or bleeding.
- In a recent study on the usage of lecanemab in individuals with the earliest phases of Alzheimer's disease, it was proven that significant adverse events, such as ARIA, are seldom encountered.
- Lecanemab, an antibody designed to combat neurological disorders, targets amyloid proteins that malfunction and form plaques in the brain, a hallmark of Alzheimer's disease and other dementia.
- In a large clinical trial, 18 months of lecanemab treatment was shown to reduce participants' memory and cognitive decline by 25-30%, compared to those not on the medication, and also led to a decrease or elimination of amyloid plaques in the brain.
- While lecanemab is currently accessible for patients, donanemab is still undergoing clinical trials. The choice of the safer treatment option depends on the specific risk factors, particularly regarding the risk of ARIA, allowing medical professionals to offer patients the most suitable treatment based on potential risks and benefits.
