arsenal09490

arsenal09490 t1_iyboubb wrote

Reply to comment by Relevant_synapse in Alzheimer’s Drug In Development, Lecanemab, May Benefit Some Patients But Carries Risks of Brain Swelling and Bleeding by Relevant_synapse

The rates of ARIA were concerning, but they were pretty localized in patients with ApoE ε4 carrier. Still high in non-carriers, but at least that has a better risk-benefit profile. Additionally, only 0.8% of ARIA cases were considered severe. That being said, the risk of ARIA leading to discontinuation will make it difficult to identify ideal candidates until more data comes out.

I do not think lecanemab should interfere with any DOACs or antiplatelets? However, patients on these medications may be at an increased risk of ARIA and/or brain bleeds (especially if the have a stroke and need tPA). So the potential additive blood thinning effect may further limit the population this drug could be used in.

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arsenal09490 t1_iybcye3 wrote

Reply to Alzheimer’s Drug In Development, Lecanemab, May Benefit Some Patients But Carries Risks of Brain Swelling and Bleeding by Relevant_synapse

The full trial can be found in today's issue of NEJM: van Dyck CH, Swanson CJ, Aisen P, et al. Lecanemab in Early Alzheimer’s Disease. NEJM. 2022;387(22):E-pub ahead of print. DOI: 10.1056/NEJMoa2212948

Overall, this does appear to be a promising treatment. Upon reading the study, my biggest criticism is that the primary endpoint is not a tool validated for measuring Alzheimer's progression. CDR-SB is mainly used for initial staging and diagnosis. However, the secondary endpoints that better assess progression were also significant, which does point toward an efficacious medication.

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