The nearly 7 million Americans affected by Alzheimer’s disease were given new hope when the Food and Drug Administration (FDA) gave full approval of the drug lecanemab (Leqembi™) this past July. Lecanemab is a breakthrough monoclonal antibody that targets and removes an abnormal form of amyloid, a protein that builds in the brains of people with Alzheimer’s. This past month, UConn Health began offering lecanemab to patients with mild cognitive impairment or mild dementia due to Alzheimer’s disease.
Lecanemab works by lowering the level of abnormal beta-amyloid protein in the brain. This approach doesn’t stop the disease process and does not improve cognitive symptoms or functional abilities. Rather, it slows the rate of cognitive and functional decline. In the Phase 3 research study, the group treated with lecanemab had slower decline on cognitive tests and activities of daily living than the group that received placebo (about 5 months slower decline over the 18 months of the trial). The benefit is likely different from person to person and at different stages of the disease.
The team at the Dr. James E.C. Walker Memory Assessment Program at the UConn Center on Aging collaborated with faculty in the departments of radiology, neurology, emergency medicine, inpatient medicine, laboratory medicine, pharmacy, the infusion center, and ancillary services to offer this treatment to qualified patients. This multidisciplinary team will ensure the coordination of each individual patient’s care.
Not every patient with an Alzheimer’s diagnosis will qualify for this kind of medicine. Patients who qualify for lecanemab are a small selective group. The team at the James E.C. Walker Memory Assessment Program will perform a thorough assessment to determine patient eligibility and risk of side effects. The team will also monitor safety and outcomes for all UConn Health patients who receive lecanemab.
Lecanemab is administered as an infusion every two weeks for at least 18 months. Each infusion lasts about one hour followed by post-infusion monitoring. Treatments are given in the Infusion Center on the 4th floor of the Outpatient Pavilion at UConn Health. In addition to infusion visits and regularly scheduled visits with referring providers, patients receiving lecanemab will have several MRIs to look for any brain changes caused by the treatment.
As with all medications, there are potential side effects that some participants may experience. Most symptoms were mild and temporary including headache, confusion, dizziness, changes in vision, nausea, or difficulty walking. However, lecanemab can cause small areas of swelling or bleeding in the brain called amyloid related imaging abnormalities (ARIA). ARIA is usually not symptomatic and is detected on regularly scheduled MRI scans. Patients who develop ARIA will be monitored closely, and some patients may need to stop treatment.
Several patients have qualified and are ready to start therapy. More are scheduled to meet with providers to go through the assessment, review and therapy plan.
“Patients are excited about a new era of Alzheimer’s disease management. At the same time there are mixed feelings, of the unknown, it is a different and new kind of therapy with a lengthy process. Our program and team worked hard to make this a patient and family friendly journey providing support along the whole process,” says Dr. Yazeed Maghaydah, co-director of the James E. C. Walker Memory Assessment Program.
“Not everybody is going to be a candidate for this medication; however, at UConn Health we have a variety of supports and treatment strategies for people with Alzheimer’s disease. The Memory Assessment Program at the UConn Center of Aging is here to help support patients and caregivers,” says Dr. Kristina Zdanys, also co-director of the Memory Program.
More information on Alzheimer’s disease, dementia, and other memory issues as well as the services and expertise of the Center on Aging at UConn Health can be found at Center on Aging or by calling (866) 328-8086.
