II. Indications
- Alzheimer's Disease with Amyloid Beta Plaque
III. Precautions
- Aducanumab, the prototype, was FDA approved in 2021 with much controversy
- FDA over-rode its own advisory committee's vote (10 against and 1 in favor) to not approve
- Lecanemab was FDA approved via the accelerated approval pathway in 2023, with little better evidence
IV. Medications
- Aducanumab (Aduhelm)
- Monoclonal Antibody infused IV every 4 weeks at a cost of $28,200 to $56,000 per year
- Lecanemab (Leqembi)
- Monoclonal Antibody infused IV every 2 weeks at a cost of $26,500 per year
V. Efficacy
- May reduce amyloid beta Plaque, but does not appear to improve cognitive function
VI. Adverse Effects
- Risk of CNS microhemorrhages and edema
- Requires 3 MRIs in first 12 to 18 months of use
VII. References
- (2023) Presc Lett 30(4): 24
- (2021) Presc Lett 28(8): 43
- Walsh (2021) BMJ 374:n1682 [PubMed]