Early Clinical Use of Anti-Amyloid Therapy for Alzheimer Disease in Japan: Takeshi Iwatsubo, MD, PhD

WATCH TIME: 4 minutes

"The real-world safety profile of this treatment is quite encouraging, with lower adverse event rates compared with global clinical trials."

In the US, the FDA has started to approve “disease-modifying treatments” for Alzheimer disease (AD), including lecanemab (Leqembi; Eisai), which gained full traditional approval by the agency and full coverage by the Center for Medicare Services earlier this year. In clinical studies, these anti-amyloid monoclonal antibodies demonstrated both biomarker efficacy and slowing of clinical progression of AD through cognitive and functional measures. Despite the efficacy data, the potential serious adverse effects of these therapies have triggered a concern from clinicians that their more widespread use may induce greater risk.

Recently presented real-world data indicated that clinical experience with lecanemab closely mirrored that observed in clinical trials. Although there remained a minor risk of unavoidable serious adverse events, the treatment demonstrated good usability, safety, and tolerability overall, according to study authors. Presented at the 2024 Clinical Trials on Alzheimer’s Disease (CTAD) conference, held October 29 to November 1, in Madrid, Spain, during a late-breaking symposium, the analysis study included 148 patients who were prescribed lecanemab in the academic practice, including many who would not have met clinical trial eligibility inclusion criteria.

During the symposium, lead author Takeshi Iwatsubo, MD, PhD, professor of neuropathology at the University of Tokyo School of Medicine, also presented an update on the use of lecanemab in clinical practice for Alzheimer disease in Japan. At the conference, Iwatsubo sat down with NeurologyLive^® to further discuss how the safety profile of this antiamyloid therapy differed between Japanese patients and global clinical trial data. He also spoke about the current limitations in accessing comprehensive genotyping data for this treatment in Japan. Moreover, Iwatsubo talked about the future directions that are being considered to enhance AD treatment, particularly in terms of inhibiting downstream pathways.

Click here for more coverage of CTAD 2024.

REFERENCES
1. Honig L, Bell K, Gonzalez W, et al. Lecanemab Use in Clinical Practice at an Academic Medical Center. Presented at: 2024 CTAD; October 29-November 1; Madrid, Spain. LBS2. Presentation 2.
2. Iwatsubo T. Lecanemab Use in Clinical Practice in Japan. Presented at: 2024 CTAD; October 29-November 1; Madrid, Spain. LBS2. Presentation 3.