Lecanemab information

General information

Lecanemab is one of the first Alzheimer’s treatments designed to remove amyloid protein in the brain, and has been approved by the FDA for treatment of patients with “mild cognitive impairment” and mild dementia stages of Alzheimer’s disease. 

Generic name: lecanemab
Brand name: LeqembiTM
Made by: Eisai and Biogen

What is it proven to do?

  • Remove beta amyloid protein from the brain, which is one of the Alzheimer’s proteins. 
  • Slow the worsening of Alzheimer’s disease to a modest degree (27% over 18 months), based on the cognitive and functional test, Clinical Dementia Rating-Sum of Boxes.

What is it not proven to do?

  • Improve the thinking ability or memory of patients.

What are the patient requirements?

  • Diagnosed with “mild cognitive impairment” or mild Alzheimer’s disease.
  • Must have had a spinal tap, beta amyloid PET scan, or beta amyloid blood test, depending on patient and provider preferences. If positive, these tests prove that beta amyloid protein is accumulating in the brain. Medicare and insurance have typically covered the cost of the spinal tap. At this time, Medicare does not cover the cost of the PET scan or the blood test. Insurance company coverage for the PET scan and the blood test may be limited or not covered.
  • General health should be relatively stable.
  • Brain MRI scan must have been done within one year that is consistent with Alzheimer’s disease and not show evidence of multiple microhemorrhages.
  • MRI scans will be required for surveillance of side effects, including one at baseline and three additional in the first year. Additional scans may be needed over time. 

What are the possible side effects?

21.5% of patients in one large study experienced some degree of brain swelling or microhemorrhages (microscopic strokes), which in most cases resolved or were relatively minor. As of January 10, 2023, three patients of approximately 900 have died, possibly due to complications of LeqembiTM treatment.

What is the cost?

Anticipated cost is $26,500 annually for the drug itself, not including cost of infusions. Medicare, insurance coverage and/or patient access program availability is uncertain at this time. 

How often is it given?

Twice monthly intravenous infusions. It is unknown at this time how long the drug should be administered, but initial studies support at least 18 months.

Can it be taken with other drugs?

Lecanemab can be prescribed with or without: donepezil, rivastigmine, galantamine, and memantine.