Alzheimer’s disease gradually worsens over time, and there’s no cure for it yet. Leqembi (lecanemab) is a new type of medicine that can slow down how quickly Alzheimer’s disease gets worse.
Leqembi is a treatment for people who are in the early stages of Alzheimer’s disease, when their symptoms are still mild. Treatment with Leqembi may help some people have more time to do everyday activities and live independently before their Alzheimer’s disease becomes more severe.
How Does Leqembi Work for Alzheimer’s Disease?
Leqembi helps people with Alzheimer’s disease have a longer time to live independently and function normally.
At first, people with Alzheimer’s disease may have mild symptoms, like trouble remembering names or forgetting recent events. As time goes on, more severe symptoms may appear, like mood changes or confusion about time and place. Eventually, people with Alzheimer’s disease may become unable to communicate or live independently. Leqembi is a treatment for people who are in the early stages of Alzheimer’s disease, when their symptoms are still mild.
In the brain of someone with Alzheimer’s disease, a protein called amyloid beta builds up and forms harmful clumps, called amyloid beta plaques. These plaques can interfere with communication between brain cells, which is one reason why people with Alzheimer’s disease may forget things or have trouble thinking clearly. Leqembi is a medicine that targets amyloid beta plaques in the brains of people with Alzheimer’s disease. It helps to clear the plaques away, which can slow down the rate of worsening memory and thinking problems.
How Do I Take it?
Your health care provider will give you Leqembi as an intravenous (IV) infusion at a hospital or clinic. The right dose will be calculated based on your body weight. They will use a needle to inject the medicine through a vein.
Leqembi IVs are usually given once every 2 weeks. Each IV session lasts about an hour, but your appointment will take longer than an hour. Your health care provider will watch you closely during and after your IV to make sure you feel well and are not having a reaction.
Your health care provider will run tests to make sure it's safe for you to receive the IV. Before you get your first infusion, your health care provider will check your brain with a scan called magnetic resonance imaging (MRI). The MRI scan detects beta amyloid beta plaques linked to Alzheimer’s disease. Your health care provider will run tests again after you’ve been taking Leqembi to see how it’s working for you.
It’s important to follow the IV schedule recommended by your health care provider. Missing doses can make Leqembi less effective. Always talk to your health care provider if you have questions or if you cannot make it to an IV appointment.
How Was It Studied for Treating Alzheimer’s Disease?
Leqembi was tested in two clinical studies to see if it could help people with early Alzheimer’s disease who had mild symptoms that had recently started. These people also had signs of amyloid beta proteins in their brains – a substance linked to Alzheimer’s disease. The studies did not include people with moderate or severe symptoms. Leqembi was given as a shot every 2 weeks, at a dose of 10 milligrams per kilogram of the person's body weight. People in the studies did not know if they were getting Leqembi or a placebo.
Amyloid beta plaques. The first clinical study tested Leqembi in 856 people with early Alzheimer’s disease and mild symptoms. The average age of people in the study was 71 years. Half of the people in the study were male, and most were White (90%).
Efficacy was measured by the amount of amyloid beta plaques in the brain. After 79 weeks of treatment, the people who took Leqembi had less amyloid beta plaque in their brain. Along with having less brain plaque, people who took Leqembi had slower worsening of thinking problems.
Alzheimer’s disease symptoms. The second study tested 1,795 people with early Alzheimer’s disease and mild symptoms. The average age of people in the study was 72 years. A little more than half of the people in this study were female (52%). Of the people in the study, 77% were White, 17% were Asian, and 3% were Black. Patients and their caregivers were interviewed to evaluate their Alzheimer’s symptoms during the study. They were also interviewed about how well they could do ordinary daily activities independently, like getting dressed and finding personal belongings.
Efficacy was measured by the worsening of their symptoms, such as problems with memory and problem-solving. After 18 months, people who took Leqembi had slower worsening of their Alzheimer’s symptoms. People who took Leqembi also had a slower loss of their ability to do ordinary daily activities independently.
What Are the Benefits?
Leqembi works by slowing down Alzheimer’s disease in people who are just starting to have memory or thinking problems. It can help people maintain independence and thinking skills longer.
Identifying Alzheimer’s disease early and starting management promptly are important steps that can slow the progression of symptoms. Treatments like Leqembi are designed to intervene at this early stage, providing patients with more quality time before their symptoms get worse.
In research, people with early Alzheimer’s disease who took Leqembi did not get worse symptoms as quickly as the people who took the placebo. They were better at remembering things, solving problems, and managing daily life.
How Can I Tell if Leqembi Is Working?
If Leqembi is working, you should have slower worsening of memory and thinking problems over time. You might not notice any difference when you take Leqembi, because it works over a longer time period of months or years.
There is no evidence that Leqembi can restore lost memories or reverse thinking problems that have already been caused by Alzheimer’s disease. Leqembi only works to slow down how quickly Alzheimer’s disease gets worse.
Your health care provider will run tests to check your brain health, and they’ll also ask you questions designed to measure your memory and thinking.
Tell your health care provider if your thinking or memory problems get worse.
Who Should Use Leqembi for Alzheimer’s Disease?
Leqembi is a medicine for adults who are just starting to have Alzheimer’s disease and have mild symptoms. Health care providers will check if these people have amyloid beta plaques in their brains, because Leqembi works on these plaques.
Alzheimer’s disease gets worse over time, and Leqembi is for people who are still in the beginning stages of the disease. People with early Alzheimer’s disease can usually have mild symptoms and live independently without too much daily support. It is not for people with moderate or severe Alzheimer’s disease symptoms who have had Alzheimer’s disease for a long time.
Not everyone can use Leqembi. It is not for people with severe dementia or other types of memory problems that do not have amyloid beta plaques. It’s important to talk to your health care provider to see if Leqembi is right for you.
Are There Any Reasons That I Should Not Use Leqembi?
Some people have a genetic risk factor called homozygous apolipoprotein E gene carriers. This genetic risk factor may increase the risk of a serious potential side effect called amyloid-related imaging abnormalities (ARIA). Your health care provider may do genetic testing to see if you have this risk factor before prescribing Leqembi.
What Are Possible Side Effects?
The most common side effects of Leqembi are headache, infusion-related reactions (see below), and amyloid-related imaging abnormalities (ARIA) (see below).
Infusion-related reactions. Infusion-related reactions are a common side effect of Leqembi that can be serious. Infusion-related reactions are more common when someone gets their first IV of Leqembi, but it can happen on a later IV. Symptoms of an infusion-related reaction include fever, dizziness, chills, body aches, heart rate changes, and shortness of breath. Your health care provider will watch you closely during and after your IV to watch for infusion-related reactions.
Amyloid-related imaging abnormalities (ARIA). Amyloid-related imaging abnormalities (ARIA) is a potential side effect of Leqembi that can cause serious brain problems, like swelling or bleeding inside the brain. Most people who have ARIA don’t have any symptoms. If people do get ARIA, their symptoms are often mild and go away on their own. Sometimes, ARIA can be serious or life-threatening. Your health care provider will monitor your brain for signs of ARIA using magnetic resonance imaging (MRI) scans. If you suddenly feel very confused, dizzy, or have a bad headache, tell your health care provider right away. These could be signs of serious side effects.
These are not all of the possible side effects of Leqembi. Talk with your health care provider if you are having symptoms that bother you. If you experience anything that you think may be caused by Leqembi, you can also report side effects to the FDA at 800-FDA-1088 (800-332-1088).
What Medicine Interactions Can Happen?
Tell your health care provider if you take any medicines to reduce blood clots from forming, such as apixaban (Eliquis), aspirin, or warfarin (Coumadin, Jantoven). Medicines to reduce blood clots from forming can increase the risk of bleeding in the brain while you’re taking Leqembi.
This is not a complete list of medicines that may interact with Leqembi. Tell your pharmacist or other health care provider about all the prescription or over-the-counter (OTC) medicines, vitamins/minerals, herbal products, or other supplements you take or have recently taken. This will help them find out if there are any interactions with Leqembi or if you need a dosage adjustment.
Is a Cost Savings Program Available?
There is a patient support program that provides information and resources to help you get access to Leqembi and afford the cost. You can find out more by contacting Eisai Patient Support at 833-453-7362 or visiting https://www.eisaipatientsupport.com/.
For questions about cost or insurance coverage, you can contact the drugmaker at 888-274-2378 or visit https://www.leqembi.com/.
