Leqembi (Lecanemab-Irmb) for Alzheimer's

Overview
Leqembi is approved by the U.S. Food and Drug Administration (FDA) for the treatment of Alzheimer’s disease. It is specifically indicated for individuals in the mild cognitive impairment or mild dementia stage of the disease. Before starting treatment, the presence of amyloid beta pathology must be confirmed. Leqembi is also known by its drug name, lecanemab-irmb.

Leqembi belongs to the category of monoclonal antibodies. It works by targeting and reducing the buildup of beta-amyloid plaques in the brain, which are believed to contribute to the progression of Alzheimer’s disease. By reducing these plaques, Leqembi may help slow cognitive decline associated with the condition.

How do I take it?
Prescribing information states that Leqembi is administered as an intravenous (IV) infusion. The recommended dosage is once every two weeks for 18 months. After 18 months, treatment may continue either every two weeks or every four weeks. Each infusion lasts approximately one hour and should be given exactly as prescribed by a healthcare provider. Baseline brain MRI scans should be obtained before starting treatment, and additional MRIs are required before the 5th, 7th, and 14th infusions to monitor for amyloid-related imaging abnormalities (ARIA).

Side effects
Common side effects of Leqembi include infusion-related reactions, amyloid-related imaging abnormalities (ARIA, referring to changes seen in brain imaging) with microhemorrhages (small brain bleeds), edema (swelling due to fluid buildup in tissues), effusion (abnormal fluid accumulation in a body cavity), and headaches.

Rare but serious side effects may include severe cases of ARIA, serious intracerebral hemorrhages (brain bleeds greater than 1 centimeter), and symptoms that may mimic an ischemic stroke (caused by reduced blood flow to the brain). Individuals who are ApoE e4 homozygotes (people who have inherited two copies of the APOE4 gene variant) have a higher risk of ARIA. Genetic testing for APOE4 status is recommended before starting treatment.

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Label: Leqembi — Lecanemab Injection, Solution — DailyMed