Real-world Clinical, Safety and Patient-reported Outcomes of Treatment with Lecanemab in a New England Alzheimer’s Disease Center
Salvatore Napoli1, Rachel O'Donnell1, Emily Maize1
1Alzheimer’s Neurology and Infusion Centers of New England
Objective:
To provide real-world experience with individuals with early AD who were treated with lecanemab in a retrospective study at our neurology center.
Background:
Lecanemab has been shown to reduce a complex group of protein interactions associated with early Alzheimer’s disease (AD) and slow decline on clinical endpoints of cognition and function for up to 48 months to date. Lecanemab was well tolerated in clinical trials, with common adverse events including amyloid-related imaging abnormalities (ARIA) and infusion reactions.
Design/Methods:
Data collection included patient demographic characteristics, clinical history, lecanemab treatment exposure, and time from diagnosis to treatment. Assessments included Mini-Mental State Examination (MMSE), Montreal Cognitive Assessment (MoCA) Test for Dementia, and safety measures. Clinician perspectives from our real-world experience with lecanemab and patient survey feedback on subcutaneous lecanemab were collected.
Results:
Overall, 47 patients with early AD were included in the data analysis. Most of the patients were Caucasian (85%) and female (63%), with a mean age of 74 years. The most common diagnosis was mild AD (68%), and 66% of patients were ApoE4 carriers (51% heterozygotes; 15% homozygotes). Eight patients were initially on aducanumab and successfully transitioned to lecanemab. At 6 and 12 months, mean MMSE (baseline:23.8; 6-months:23.5; 12-months:23.4) and mean MoCA scores (baseline:18.7; 6-months:19.0; 12-months:18.2) were generally maintained or improved. The overall safety profile for lecanemab was similar to that observed in published clinical trials. One asymptomatic ARIA-E (2.2%) case, 2 asymptomatic ARIA-H (4.4%) cases, one symptomatic ARIA-E case (resolved), and 14 infusion-site reactions (31.1%) were observed. Of the survey responders, 93.5% (n=31, mean follow-up 298 days) reported feeling ‘very satisfied’ (20/31) or ‘satisfied’ (9/31) with lecanemab treatment and experiencing stabilization or slowing of disease progression on lecanemab.
Conclusions:
Real-world evidence of lecanemab were consistent with published clinical trials, with no new safety signals and consistently positive patient-reported outcomes.
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