"This new class of medications for early symptomatic Alzheimer's is the only approved treatment that influences disease progression. But fear surrounding the drug's potential side effects can lead to treatment delays,” study co-author, Barbara Joy Snider, MD, PhD, professor of neurology at Washington University School of Medicine, said in a press release.
Lecanemab was approved by the FDA in July 2023 for Alzheimer’s disease. Until now, however, the drug's feasibility and safety in clinical practice have been unclear, especially in light of the drug's side effects such as amyloid-related imaging abnormalities (ARIA) with edema/ effusion (ARIA-E) and/ or hemorrhage/hemorrhage deposition (ARIA-H).
In the current study, researchers conducted a retrospective analysis of patients who took lecanemab between August 1st 2023 and October 1st 2024 at an outpatient clinic. Altogether, 234 patients with a mean age of 74 years old underwent treatment for an average of 6.5 months.
Ultimately, the researchers found that 22% of patients developed ARIA, including 29 who developed ARIA-E, and 13 who developed isolated ARIA-H. While patients with mild dementia had a 27% rate of symptomatic ARIA, those with mild cognitive impairment or very mild dementia had a 1.8% rate. No patients developed a macrohemorrhage or died.
"Patients with the very mildest symptoms of Alzheimer's will likely have the greatest benefit and the least risk of adverse events from treatment. Hesitation and avoidance can lead patients to delay treatment, which in turn increase the risk of side effects. We hope the results help reframe the conversations between physicians and patients about the medication's risks,” said Snider.
Sources: Science Daily, JAMA Neurology