Lecanemab in Clinical Practice: Real-World Treatment Outcomes from a Retrospective Neurological Clinic Case Series Review in Early Alzheimer’s Disease
Objective:
To support well-documented clinical trial data in early Alzheimer’s disease with real-world information on lecanemab treatment outcomes from clinical practice.
Background:
In clinical trials, lecanemab, the anti-amyloid monoclonal antibody, significantly reduced amyloid markers and slowed clinical decline on multiple measures of cognition and function.
Design/Methods:
This retrospective case series evaluated individuals with early AD administered lecanemab treatment over the past 18 months at the Denver Neurological Clinic in Colorado. Available chart data included medical history, demographic characteristics, lecanemab treatment exposure, safety, and the Kokmen Mental Status Exam (KMSE) as a measure of real-world cognitive efficacy for patients receiving ≥6 months lecanemab.
Results:
Overall, 44 individuals with early AD (mild AD:24; mild cognitive impairment:20) treated with lecanemab were included (15 with baseline and post-baseline assessments at cutoff). Patients had a mean age of 75.5 years and a majority were male (55%) and Caucasian (100%). A total of 21 patients (48%) were ApoE4 carriers (36% heterozygotes; 11% homozygotes). The average duration of treatment was 7.4 months (range: 1–18 months), with a duration of 9.9 months in the efficacy assessment (ie, ≥6 months treatment). Four patients switched safely from aducanumab to lecanemab treatment. For the 15 patients with KMSE baseline and post-baseline scores, 6 patients had improved scores and 4 had stable scores (within 10% of baseline). There were 4 cases of ARIA: 2 asymptomatic ARIA-H (continued treatment), 1 asymptomatic ARIA-E (continued treatment), and one patient with symptomatic, severe ARIA-E and ARIA-H (discontinued). Three additional patients discontinued.
Conclusions:
In a real-world clinical practice setting, the lecanemab efficacy and safety profile was similar that observed in clinical studies. Practical operational models using existing infrastructure can be implemented in the community setting.
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