Lecanemab Treatment in a Specialty Memory Clinic

Two monoclonal antibodies targeting amyloid plaques, lecanemab and donanemab, have received traditional US Food and Drug Administration (FDA) approval for the treatment of early symptomatic Alzheimer disease (AD). The most significant adverse events associated with these therapies are infusion-related reactions and amyloid-related imaging abnormalities (ARIA) with edema/effusion (ARIA-E) and/or hemorrhage/hemosiderin deposition (ARIA-H). The feasibility and safety of providing these treatments in clinical practice is unclear.

To examine the feasibility and safety of treating patients in specialty memory clinics with lecanemab. Design, Setting, and Participants: This retrospective analysis of consecutive patients in whom lecanemab was initiated between August 1, 2023, and October 1, 2024, at Washington University Memory Diagnostic Center, an outpatient specialty memory clinic. Lecanemab was initiated in 234 patients with early symptomatic AD. Eligibility was based on the FDA label and appropriate use recommendations with occasional exceptions. Exposure: Patients were treated with lecanemab, 10 mg/kg, intravenously every 2 weeks. Main Outcomes and Measures: Infusion-related reactions, ARIA, and withdrawal from treatment were assessed.