Continuous Dosing of Lecanemab for Alzheimer’s Disease

EP: 1.Presentation of Alzheimer’s Disease in Clinical Practice

EP: 2.Diagnosis and Treatment of Alzheimer’s Disease

EP: 3.Lecanemab for Treatment of Early Alzheimer Disease

EP: 4.ARIA With Monoclonal Antibody Treatments for Alzheimer Disease

EP: 5.Clarity-AD-OLE Study in Alzheimer’s Disease

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EP: 6.Continuous Dosing of Lecanemab for Alzheimer’s Disease

EP: 7.Donanemab for Treatment of Alzheimer’s Disease

EP: 8.Biomarkers in Alzheimer’s Disease (May 2025)

EP: 9.Emerging Agents in Alzheimer’s Disease

Summary for Physicians

Longer-Term Data and Lecanemab as Maintenance Therapy

Efficacy and Safety of Maintenance Therapy:

• The long-term data from the Clarity AD OLE study support the potential for lecanemab to be used as a maintenance therapy for patients with early Alzheimer’s disease.
• The sustained reduction in amyloid plaques, continued slower cognitive decline, and stable safety profile through ongoing infusions suggest that maintenance therapy can offer prolonged benefits without compromising patient safety.
• Longer-term efficacy data reveal that early and sustained amyloid reduction leads to continued benefits in cognition and functional capacity, reinforcing the idea that ongoing therapy may delay the progression from MCI to dementia.
• Safety remains manageable, with no new major safety concerns over time, especially with consistent monitoring for ARIA.

Impact of Infusion Frequency on Patient and Caregiver Quality of Life

FDA’s Approval of Every-4-Week Infusion Schedule:

• The reduced infusion frequency (every 4 weeks vs. every 2 weeks) is a significant development for patient and caregiver quality of life.
• Patient Convenience: Less frequent visits improve convenience, reducing time off work, travel burdens, and the general strain of more frequent infusions.
• Caregiver Burden: Caregivers often bear the logistical and emotional load of accompanying patients to infusions. The new regimen can ease this burden, promoting better caregiver engagement and reducing caregiver stress.

Impact on Adherence:

• The more spaced-out infusion schedule increases adherence, as it may be easier for patients and families to commit to fewer visits, which can optimize therapeutic outcomes over the long term.
• Fewer infusions can also reduce the disruption to daily life, making it easier to integrate treatment into the patient's routine without major adjustments.

Long-Term Use of Lecanemab: Impact on Alzheimer’s Disease Progression

Potential to Alter Alzheimer’s Disease Trajectory:

• Long-term lecanemab use may help to extend the window of higher functioning for patients with Alzheimer’s disease. By continuously reducing amyloid plaques, it could delay cognitive decline and maintain functional independence for a longer period.
• Slower Progression: Data suggest that maintaining low levels of amyloid-beta over time could lead to less severe functional decline, with patients experiencing milder symptoms for a longer duration.
• Shift in Treatment Paradigms: The notion of disease-modifying agents as long-term, maintenance treatments may shift Alzheimer’s management from a palliative approach to one that actively delays disease progression. This has the potential to change the course of Alzheimer’s, making it more manageable and allowing patients to maintain quality of life for longer.

Key Takeaways

• Maintenance Therapy: The data strongly support the continued use of lecanemab as a maintenance therapy, offering long-term cognitive and functional benefits for patients with early-stage Alzheimer’s disease.
• Infusion Frequency: Reducing infusion frequency to every 4 weeks significantly improves patient and caregiver quality of life, with the potential to enhance treatment adherence and reduce caregiver burden.

Impact on Disease Progression: Longer-term dosing with lecanemab could alter the trajectory of Alzheimer’s disease, potentially slowing cognitive decline and delaying the need for more intensive care.