New Drug Offers Hope for Early-Stage Alzheimer's Disease

Alzheimer’s disease is a progressive brain disorder that gradually destroys memory, thinking skills and, eventually, a person’s ability to perform even simple tasks. Few treatments have existed, but a new drug offers hope for patients with mild cognitive impairment and mild dementia due to early-stage Alzheimer’s disease.

“It’s not an exaggeration to say Leqembi represents a revolutionary development in the treatment of Alzheimer’s disease,” says Charles J. Duffy, MD, PhD, neurologist and Director of UH Neurological Institute’s Brain Health & Memory Center. “In fact, Leqembi is the first disease-modifying therapy approved in the U.S. for the treatment of the disease.”

Understanding Alzheimer’s Disease

The causes of Alzheimer’s disease aren’t completely understood, but a buildup of certain proteins in the brain is involved in the disease’s progression. One protein, called beta-amyloid, forms sticky plaques. These deposits interfere with nerve signaling and contribute to cognitive and memory problems. As a result, most drug companies have focused on developing therapies to get rid of beta-amyloid plaque.

How Does Leqembi Work?

Leqembi is a therapeutic antibody that attacks beta-amyloid plaque deposits by triggering immune cells to remove them from the brain. It isn’t a cure for Alzheimer’s disease, but it’s the first Alzheimer’s medication to change the disease state in the brain, rather than just treat its symptoms.

“We can’t say exactly how effective Leqembi is without further research and data,” says Dr. Duffy. “But the results of the first clinical trials are very encouraging. In practical, real-life terms, the research suggests that Leqembi may slow cognitive decline in some Alzheimer’s patients, potentially prolonging their enjoyment of daily life with their families.”

In a clinical study, early-stage Alzheimer’s patients given Leqembi therapy were shown to have 27 percent less cognitive decline than patients who did not receive the treatment. 

Potential Side Effects

Leqembi is administered as an IV infusion every two weeks. Each session lasts about one hour. After an infusion, the patient is monitored for any negative reactions.

Leqembi can cause side effects, including headaches and certain infusion reactions that can usually be managed with medications such as antihistamines, anti-inflammatory medications or steroids. More potentially serious side effects of the drug include:

• Serious allergic reactions, such as swelling of the lips, mouth, tongue or face, which may result in discontinuation of the therapy.
• Amyloid-related imaging abnormalities (ARIAs), which can include brain bleeding, swelling or a combination of both.

Symptoms associated with ARIAs include headaches, dizziness, visual changes, nausea and confusion. In rare instances, ARIAs can be fatal.

“ARIAs most often occur in patients who have a certain genetic abnormality,” says Dr. Duffy. “For that reason, we test patients to see if they have this genetic factor prior to approving and starting Leqembi therapy.”

Does Insurance Cover Leqembi?

As Leqembi is a newer medication, coverage varies among insurance providers, including Medicare and Medicaid. Patients should talk to their provider to determine coverage before beginning treatment.

“Our first patients have not had difficulty getting insurance coverage for Leqembi infusions,” says Rebecca DiFranco, RN Care Coordinator for UH Neurological Institute’s Leqembi program. Rebecca says that Medicare typically covers 80 percent of the cost for most patients, with supplemental insurance often picking up the remaining 20 percent. What’s more, the drug’s manufacturer, Eisai Company Limited, offers a patient assistance program for those who qualify.

Related Links

The specialized brain health and memory team at University Hospitals Neurology Institute, offers comprehensive treatment for Alzheimer’s disease.