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AAN 2025 | Real-world outcomes with lecanemab in early Alzheimer’s disease

Justin Moon, MD, MPH, Denver Neurological Clinic, Denver, CO, comments on the real-world experience with lecanemab therapy for Alzheimer’s disease. He highlights the successful implementation of the treatment and comparable clinical outcomes to trials. Dr Moon notes that careful patient selection and close monitoring resulted in fewer adverse reactions, good tolerability, and compliance, with most patients experiencing mild symptoms that resolved. He also observes that some patients fared better on a twice-monthly infusion schedule, suggesting potential benefits of adjusting dosing frequency. This interview took place at the 77th American Academy of Neurology (AAN) Annual Meeting in San Diego, CA.

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Transcript

Yes, we were one of the early sites utilizing lecanemab therapy, and now we have patients into their 24th month. And this is a real-world experience of a small clinic, seeing patients out in the community and monitoring them over the course of the last several years. We have about 50 patients in the study that we’re currently publishing. We have several more that have been added since. But it gives us some field experience in terms of what can be done outside of an academic center...

Yes, we were one of the early sites utilizing lecanemab therapy, and now we have patients into their 24th month. And this is a real-world experience of a small clinic, seeing patients out in the community and monitoring them over the course of the last several years. We have about 50 patients in the study that we’re currently publishing. We have several more that have been added since. But it gives us some field experience in terms of what can be done outside of an academic center. Our findings showed that patients were able to successfully implement lecanemab in private practice. The clinical outcomes were somewhat similar to the clinical trials. We had slightly fewer adverse reactions, but then we were also very careful with our early selection of patients. And we found good tolerability and compliance with our patients. In our patient population, we actually had a slightly lower rate of ARIA. I think that had to do with patient selection early on. As we broaden it, we expect to see ARIA. And this is something that providers and clinicians should expect going in. The majority of our patients had very mild symptoms, which resolved. We did have one patient that had severe ARIA and had to stop and discontinue therapy, although the patient did return back to baseline. But we are able to continue the therapy in most cases of ARIA. One of the interesting things that we saw was that when we started patients past the 18-month point and they were going to the once a month infusion that some of those patients actually didn’t do as well and were able to stabilize when we returned them back to a twice a month infusion.

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Disclosures

Abbvie: researcher, consultant, speaker; Lilly: consultant, advisor, researcher, speaker.