Two-Year Real-World Study of LEQEMBI® in the United States Presented at Alzheimer's Association International Conference (AAIC) 2025
Lecanemab received traditional approval in the
Patient Baseline and Actual Treatment Situation
The interim study collected information on 178 people living with early AD from nine
The mean duration of lecanemab treatment was 375.4 days (± 182.8 days). The mean time from diagnosis to first treatment was 224.2 days (± 295.4 days) and the mean number of lecanemab treatments was 24.8 (± 11.5). At the time of case reporting, 87.4% of patients (152 patients) were continuing treatment with lecanemab. Adverse events leading to discontinuation of treatment included ARIA-E (ARIA-edema/exudation) in two patients (1.1%), ARIA-H (ARIA-cerebral microbleeds, cerebral hemorrhage and superficial hemosiderin deposition) in two patients (1.1%), and concomitant ARIA-E and ARIA-H in one patient (0.6%). Three patients (1.7%) discontinued due to adverse events other than ARIA. In addition, 11 patients (6.3%) reported discontinuing the treatment for personal reasons or at the discretion of their doctor or the individual.
In 83.6% of patients who participated in this study, clinical stage remained at the same disease stage, or clinical stage improved from mild dementia to MCI (stable: 76.9%, improvement: 6.7%). Additionally, 86.7% of patients who received 40 or more doses (over 18 months), at time of interim data cut remained stable or clinically improved (stable: 66.7%, improvement: 20.0%:).
Of the 178 patients, ARIA was observed in 23 (12.9%). 14 (7.9%) were observed to have ARIA-E, of which 12 (6.7%) were asymptomatic. ARIA-H was present in 11 patients (6.2%), all of whom were asymptomatic. Infusion reactions were observed in four patients (2.2%). Additionally, no serious bleeding events or deaths were reported.
Impact of APOE4 Status
Of the 178 patients in this study, 12 were excluded with unknown status. Among the remaining 166 patients, 30 (18.1%) were APOE ε4 homozygotes, 84 (49.4%) were heterozygotes, 54 (32.5%) were non-carriers. Generally, the proportion of homozygotes among people with AD is thought to be 15% or more.
The incidence of ARIA was 20.0%, 9.8% and 14.8% in homozygous carriers, heterozygous carriers and non-carriers, respectively (45.0%, 19.0% and 13.0% respectively in the Phase 3 Clarity AD 18-month core study). The incidence rate of ARIA-E and ARIA-H were 13.3% and 10.0%, respectively (32.6% and 39.0% in the Clarity AD core study), which is within the FDA-approved label range. The majority of ARIA cases (0.13%) were asymptomatic. The incidence of adverse events leading to discontinuation was 16.7% in homozygous carriers, 2.4% in heterozygous carriers and 5.6% in non-carriers.
73.3% of homozygote patients' clinical stage remained stable or improved (stable: 66.6%, improved: 6.7%), 88.0% of heterozygotes patients' clinical stage remained stable or improved (stable: 83.0%, improved: 4.9%) and 85.2% of non-carrier patients' clinical stage remained stable or improved (stable: 75.9%, improved: 9.3%).
Utilization of Blood-Based Biomarkers (BBMs)
BBMs are being developed in AD to identify brain Aβ pathology and are intended for use in prescreening (triage) and confirmatory diagnosis. Of the 178 patients in this study, 49 patients (27.5%) were diagnosed using BBMs. In some of these cases (11 patients, 6.1%), it was also used for confirmatory diagnosis. Data collected from clinical practices showed the volume of tests doubling every 4 to 8 months, with BBMs using p-tau217 growing most rapidly.
Satisfaction with Lecanemab Treatment
The results of a physician, patient and care partner lecanemab satisfaction survey was presented. The survey was based on questionnaires and interviews with nine
In the physicians' evaluation, the average satisfaction level for the treatment efficacy and safety (out of 10) was 8.7. The scoring criteria included: cognition 8.1, daily function 8.1, behavioral/neuropsychiatric symptoms 7.9 and QOL 8.0. The satisfaction level of the patients as assessed by physicians was 8.8, and that of the care partners was 8.2. These results reflect the high evaluation of the efficacy and safety of lecanemab in real-world clinical practice and support the value of lecanemab.
Note:
Retrospective real-world studies can be very valuable in providing additional information to complement clinical trial data. However, there may have several limitations to keep in mind:
Potential for Biases
Data Completeness and Consistency
Data may be collected inconsistently since data collection is completed by different people at independent sites.
* Mitigation: Data inconsistency is pursued by providing site access to standardized electronic case-report forms.
Lack of
Interpretation of data may be limited since real-world studies do not utilize placebo-controlled arms.
Confounding Variables
Confounding variables are not controllable, which may impact the relationship between the exposure and outcome.
* Protofibrils are thought to be the most toxic Aβ species that contribute to brain damage in AD and play a major role in the cognitive decline of this progressive and devastating disease. Protofibrils can cause neuronal and synaptic damage in the brain, which can subsequently adversely affect cognitive function through multiple mechanisms.1 The mechanism by which this occurs has been reported not only by increasing the formation of insoluble Aβ plaques, but also by directly damaging signaling between neurons and other cells. It is believed that reducing protofibrils may reduce neuronal damage and cognitive impairment, potentially preventing the progression of AD. 2
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Notes to Editors
1. About lecanemab (generic name, brand name: Leqembi®)
Lecanemab is the result of a strategic research alliance between
Lecanemab has been approved in 46 countries and is under regulatory review in 10 countries. In
Since
2.
About the Collaboration between
3.
About the Collaboration between
Since 2005,
4.
About
In addition, we demonstrate our commitment to the elimination of neglected tropical diseases (NTDs), which is a target (3.3) of the United Nations Sustainable Development Goals (SDGs), by working on various activities together with global partners.
For more information about
5. About Biogen
Founded in 1978, Biogen is a leading biotechnology company that pioneers innovative science to deliver new medicines to transform patient's lives and to create value for shareholders and our communities. We apply deep understanding of human biology and leverage different modalities to advance first-in-class treatments or therapies that deliver superior outcomes. Our approach is to take bold risks, balanced with return on investment to deliver long-term growth.
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This news release contains forward-looking statements, including about the potential clinical effects of lecanemab; the potential benefits, safety and efficacy of lecanemab and continued treatment with lecanemab; potential regulatory discussions, submissions and approvals and the timing thereof; the treatment of Alzheimer's disease; the anticipated benefits, risks and potential of Biogen's collaboration arrangements with
These forward-looking statements are based on management's current beliefs and assumptions and on information currently available to management. Given their nature, we cannot assure that any outcome expressed in these forward-looking statements will be realized in whole or in part. We caution that these statements are subject to risks and uncertainties, many of which are outside of our control and could cause future events or results to be materially different from those stated or implied in this document, including, among others, uncertainty of long-term success in developing, licensing, or acquiring other product candidates or additional indications for existing products; expectations, plans and prospects relating to product approvals, approvals of additional indications for our existing products, sales, pricing, growth, reimbursement and launch of our marketed and pipeline products; our ability to effectively implement our corporate strategy; the successful execution of our strategic and growth initiatives, including acquisitions; the risks associated with third party collaborations; the risk that positive results in a clinical trial may not be replicated in subsequent or confirmatory trials or success in early stage clinical trials may not be predictive of results in later stage or large scale clinical trials or trials in other potential indications; risks associated with clinical trials, including our ability to adequately manage clinical activities, unexpected concerns that may arise from additional data or analysis obtained during clinical trials, regulatory authorities may require additional information or further studies, or may fail to approve or may delay approval of our drug candidates; the occurrence of adverse safety events, restrictions on use with our products, or product liability claims; and any other risks and uncertainties that are described in other reports we have filed with the
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References |
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Amin L, Harris DA. Aβ receptors specifically recognize molecular features displayed by fibril ends and neurotoxic oligomers. |
2. |
Ono K, Tsuji M. Protofibrils of Amyloid-β are Important Targets of a Disease-Modifying Approach for Alzheimer's Disease. Int J Mol Sci. 2020;21(3):952. doi: 10.3390/ijms21030952. PMID: 32023927; PMCID: PMC7037706. |
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