Northwestern MedicineLeqembi: What Physicians Need to Know About the New Alzheimer’s Drug

Dr. Ian Grant of Northwestern University shares his thoughts about the recent approval.

The Food and Drug Administration (FDA) has given full approval to Leqembi® (lecanemab), a groundbreaking drug that slows the progression of Alzheimer’s disease in its earliest stages. This marks a significant milestone in Alzheimer’s treatment, with Northwestern Medicine now offering the drug to eligible patients through the Mesulam Center for Cognitive Neurology and Alzheimer’s Disease.

Key Points

• Leqembi is not a cure for Alzheimer’s, but it does delay the disease’s progression at its earliest stages.
• In clinical trials, Leqembi resulted in a 28% slower decline compared to placebo, equating to four to five additional months of retained function.
• About one in five patients on Leqembi experience amyloid-related imaging abnormalities (ARIA), which can sometimes cause symptoms such as headache, confusion, and visual disturbance.
• Northwestern Medicine is currently offering Leqembi to patients through the Mesulam Center, with Northwestern Memorial Hospital being the only location where patients can receive the twice-monthly infusions of the drug. They plan to expand infusions to other Neurology locations by the beginning of 2024.
• Referring physicians should be aware of the exclusion criteria in the Appropriate Use Recommendations, including being on a blood thinner and being too far progressed in the disease.
• Physicians should also be aware of a new direct-to-consumer test that can measure amyloid beta proteins in plasma.
• Leqembi is priced at $26,500 per year, and monitoring and other care will add significantly to its costs; however, the drug’s manufacturer, Eisai, has established a patient assistance program to supply the drug at no cost to uninsured and financially burdened patients who meet the program eligibility criteria and Northwestern Medicine will offer financial counseling to help patients prepare.

“Leqembi is the first anti-amyloid drug shown to clearly produce a clinical change — it’s a small change but a real change. I think this could be comparable to the early days of HIV therapy. There will be further advances, and initial therapies will be built on to improve outcomes.”
— Ian M. Grant, MD, ​Assistant Professor of Neurology (Behavioral Neurology) and Neurology (Hospital Neurology)

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