Lecanemab's Real-World Usage Reveals Infrequent Adverse Effects in Alzheimer's Patients
Breakthrough Alzheimer's Drug: Lecanemab and Its Real-World Side Effects
In the ever-evolving battle against Alzheimer's disease, a debilitating form of dementia, a glimmer of hope emerged in 2023 when the U.S. FDA approved lecanemab for treating early stages of the disease. Yet, like any medication, it comes with potential side effects, the most concerning being amyloid-related imaging abnormalities (ARIA).
ARIA refers to changes observed in brain scans, indicative of localized swelling or bleeding in the brain. These changes can result from the immune system's response as lecanemab helps clear amyloid deposits, a characteristic of Alzheimer's.
As the groundbreaking Clarity AD phase 3 clinical trial reported in 2022, ARIA cases were infrequent, affecting just 0.8% of participants with the presence of edema/effusion and 0.7% showing signs of hemorrhage/hemosiderin deposition.
A recent study brings reassuring news, suggesting ARIA is both rare and manageable in real-world use of lecanemab for those with very mild or mild Alzheimer's disease. With lecanemab's approval on the horizon, let's delve deeper into the drug, its function, and the risks it poses.
What is lecanemab?
Lecanemab is an antibody, a type of protein typically produced by our immune system, but in this instance, manufactured using advanced biotechnology. Antibodies can be designed to target specific structures. In the case of lecanemab, it is engineered to recognize and neutralize misfolded amyloid proteins, a hallmark of Alzheimer's disease.
Lecanemab and Amyloid Proteins
Lecanemab was specifically designed to bind to certain types of amyloid proteins, which are produced naturally in our bodies but can misfold and interfere with brain activity, forming harmful clumps called plaques. These plaques are a key feature of Alzheimer's disease, contributing to memory loss and dementia.
In a large clinical trial, people treated with lecanemab for 18 months experienced about 25-30% less decline in memory and thinking compared to those not receiving the medication. Imaging studies also demonstrated that lecanemab significantly reduced and, in some cases, cleared amyloid plaques in the brain.
Side Effects of Lecanemab: The Rarity of ARIA
The new study, conducted by researchers at the Washington University Memory Diagnostic Center, recruited over 200 people with early-stage Alzheimer's disease for lecanemab treatment. At the study's conclusion, 1.8% of participants at the earliest stage of the disease exhibited ARIA symptoms, while 27% of those with mild Alzheimer's disease showed symptoms.
This finding underscores the significance of early diagnosis, as people with very mild symptoms stand to benefit more from the treatment, experiencing up to 40-50% slowing of decline instead of the 25-30% decline observed among the overall population.
Remarkably, in all cases, ARIA symptoms subsided within a few months, and no patients died as a result. This parallels what was observed in the clinical trial, offering a degree of reassurance that these drugs can be safely used in real-world clinical settings.
Identifying Increased ARIA Risk: The Road Ahead
The study's findings largely align with what neurologists have witnessed in their centers, such as Dr. John Dickson of Massachusetts General Hospital. While ARIA does occur in patients treated with lecanemab, it has been manageable in specialized treatment programs.
Further research is needed to identify patients at an increased risk for ARIA, particularly those with concerning symptoms or radiographic features. This would allow doctors to offer personalized recommendations regarding treatment based on individual patient risk profiles, ultimately aiding patients in making informed decisions about their treatment options.
The benefits offered by lecanemab may outweigh the potential risks for many patients, but careful consideration of disease stage, overall health, and other risk factors is essential when deciding whether to pursue treatment with anti-amyloid therapy. In the coming years, researchers hope to learn more about the long-term effects of lecanemab, as well as the benefits and risks of other potential Alzheimer's treatments like donanemab.
- In the fight against Alzheimer's disease, a neurological disorder associated with dementia, lecanemab, an antibody, was approved in 2023 for treating early stages of the disease.
- As a type of protein, lecanemab, manufactured using advanced biotechnology, is designed to target and neutralize misfolded amyloid proteins, a hallmark of Alzheimer's disease.
- A recent study on the real-world use of lecanemab revealed that ARIA (amyloid-related imaging abnormalities) is rare and manageable, especially for seniors with very mild or mild Alzheimer's disease.
- In a clinical trial, people treated with lecanemab experienced less decline in memory and thinking compared to those not receiving the medication, and imaging studies demonstrated reduced amyloid plaques in the brain.
- Further medical-condition studies and research are required to identify patients at an increased risk for ARIA, aiming to offer personalized treatments and recommendations for seniors considering therapies-and-treatments like lecanemab within the broader context of health-and-wellness, particularly for neurological-disorders such as Alzheimer's disease.
