Promising New Treatment May Slow the Progression of Alzheimer’s Disease

Lecanemab is not a cure for Alzheimer’s disease and there is no evidence this or any treatment can restore or reverse lost memories or cognitive function. However, in eligible patients, it may slow progression of the disease, enhance their ability to participate in daily life and allow them to live independently longer.

How Does Lecanemab Work?

People with Alzheimer’s disease often have an abnormal buildup of plaques in their brain that contain a protein called beta-amyloid. Lecanemab is an IV medication designed to target and remove these plaques. The first FDA approved treatment to address the underlying biology of Alzheimer’s, lecanemab therapy has the potential to slow cognitive and functional decline if started in the early stages of the disease.

Lecanemab is administered every two weeks through IV infusion, with each session lasting about one hour. Patients are monitored for a period of time after each infusion to ensure there are no negative reactions to the drug.

Who Is Eligible For Lecanemab Therapy?

Those with symptoms of early Alzheimer’s disease and the confirmed presence of beta-amyloid plaques in the brain may be eligible for treatment with lecanemab. The therapy has not been tested on people with advanced Alzheimer's or those without clinical symptoms.

Early symptoms of Alzheimer’s may include:

• Mild cognitive impairment (forgetfulness and confusion)
• Mild dementia (difficulty performing familiar tasks)

Although there is no single diagnostic test to confirm Alzheimer’s disease, physicians may use a variety of approaches to help them make a diagnosis and determine if treatment with lecanemab might be appropriate. Tests and procedures may include:

• Comprehensive personal and family medical history
• Mental status tests
• Physical and neurological exams
• Blood tests
• Spinal tap to remove a sample of cerebrospinal fluid for testing
• MRI of the brain
• PET scan of the brain to look for the presence of beta-amyloid plaques

What Are Potential Side Effects Of Lecanemab?

Like all medicines, lecanemab can have side effects, some of which are serious. Potential side effects include:

• Infusion reactions such as changes in blood pressure, changes in breathing, fever, chills and skin changes. These are usually not severe and can be managed with medications such as antihistamines, anti-inflammatory medications or steroids.
• Allergic reactions such as swelling of the face, lips, mouth or tongue. These can be serious and may prohibit continuation of the therapy.
• Headache.
• Amyloid-related imaging abnormalities (ARIA) which may include brain bleeding, swelling or a combination of both. Symptoms may include headaches, visual changes, dizziness, nausea, confusion and, in rare instances, it can be fatal. Prior to beginning lecanemab therapy, patients should be tested for a specific genetic factor that may increase their risk for ARIA.

Patients approved to receive Lecanemab therapy will be carefully monitored at set intervals as determined by their physician. Subsequent brain MRIs and lab tests will be obtained periodically to monitor for ARIA and other serious side effects of treatment.

Who Is Not a Candidate for Lecanemab Therapy?

For some people, the risks of lecanemab therapy may outweigh the benefits. Doctors will likely look for other ways to manage the disease if a patient has any of the following risk factors:

• Existing brain bleeds, brain swelling or other major brain pathology
• History of transient ischemic attack (TIA), stroke or seizures within the past 12 months
• Uncontrolled bleeding disorder
• Immunological disease that requires treatment with systemic medications
• Serious hypersensitivity to lecanemab

Is Lecanemab Covered by Insurance?

This is a new medication and coverage will vary among insurance providers including Medicare and Medicaid. Patients are advised to talk to their provider to determine coverage before beginning treatment.