Lecanemab Preserves Memory: Alzheimer’s Trial Results
Lecanemab Shows Sustained Benefit in Long-Term Alzheimer’s Study, Safety Profile Remains Consistent
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New long-term data from the CLARITY-AD trial demonstrate continued clinical benefit and a consistent safety profile with up to four years of continuous lecanemab treatment for early-stage Alzheimer’s disease (AD). The findings, presented at a recent medical conference, offer encouraging evidence that the drug may slow cognitive decline and possibly provide sustained improvements over time.
Long-Term Efficacy Data Bolsters Lecanemab’s Promise
The open-label extension phase of the CLARITY-AD study followed participants who initially received lecanemab or placebo in the pivotal trial. Results indicate that the positive effects observed in the original trial were maintained, and in some cases, improved with extended treatment.
Specifically, 64% of patients treated with lecanemab showed improvement or no decline on the Clinical Dementia Rating-Sum of Boxes (CDR-SB) scale, a key measure of cognitive function. Furthermore, 58% of patients demonstrated actual improvement in their clinical scores. These results suggest a potential for disease modification,a important advancement in the treatment of Alzheimer’s.
“These findings suggest that starting and maintaining treatment with lecanemab in early-stage AD may help slow clinical decline and may provide sustained benefits over the long term,” explained Christopher van Dyck, MD, the study’s lead investigator.
Safety Profile Remains Favorable Over Four Years
A key concern with lecanemab has been the risk of amyloid-related imaging abnormalities (ARIA), particularly ARIA-E (edema) and ARIA-H (hemorrhage).However, the long-term data reveal a reassuring trend: the incidence of ARIA decreased after the initial 12 months and remained stable throughout the four-year treatment period.
ARIA-E: Rates declined from 13% at less than 12 months to just 1% at 36-48 months.
ARIA-H: Rates decreased from 15% at less than 12 months to 9% at 36-48 months.
Importantly, no new safety signals were observed during the extended treatment period. Van Dyck noted that the frequency of most adverse events actually decreased over time, with none increasing in incidence. This suggests that the body may adapt to the treatment, minimizing initial side effects.
Expert Perspectives on the Data
The long-term data have been met with enthusiasm from the Alzheimer’s research community. Rebecca M. Edelmayer, PhD, vice president of scientific engagement for the Alzheimer’s Association, called the findings “exciting,” emphasizing the continued less decline and potential for improvement in clinical scores alongside the consistent safety profile. She also highlighted the alignment of these results with “real-world” data from clinics using lecanemab.
Howard Fillit, MD, co-founder and chief science officer of the Alzheimer’s drug Revelation Foundation, described the data as a “major advance.” He acknowledged the lack of a stable control group in the open-label extension, relying on historical data for comparison. However, he emphasized the meaning of patients showing improvement or stability over time with continued lecanemab dosing.
“It’s actually pretty amazing because not only has this historically been thought of as a chronic, uniformly progressive and ultimately fatal disease, but we never really thought that there would be a drug…that would actually improve patients on a disease-modifying basis as this drug seems to do,” Fillit stated. He also noted the favorable risk-benefit profile, with a low rate of serious side effects.
Subcutaneous Formulation Could Expand Access
Fillit also highlighted the potential impact of a subcutaneous formulation of lecanemab, currently under FDA review. If approved, this would allow for at-home dosing, considerably reducing the burden and inconvenience associated with intravenous infusions. This increased accessibility could be a “game changer” for patients.
The FDA is expected to make a decision on the biologics license application for the lecanemab subcutaneous autoinjector later this month.
Disclosure
The CLARITY AD study was funded by Eisai and Biogen. Christopher van Dyck has been an advisor/consultant for Eisai, Roche Pharmaceuticals, Ono Pharmaceuticals, Bristol Myers Squibb, Cerevel, and UCB.