Alzheimer Disease Imaging
In the Era of Anti-Amyloid Treatment
The landscape of diagnostic evaluation and treatment of Alzheimer disease (AD) is rapidly changing. While there is still no cure for Alzheimer, recent developments are bringing increased hope to the millions of Americans suffering from this progressively debilitating condition.
What is Lecanemab?
In July 2023, the US Food and Drug Administration (FDA) approved Leqembi® (lecanemab), a monoclonal antibody (MAB) co-manufactured by Eisai and Biogen, for treatment of early-stage AD. This decision was the catalyst for the Centers for Medicare & Medicaid Services (CMS) to immediately affirm that the agency would cover the medication broadly.
Who is a candidate for Lecanemab?
It is important to note that Leqembi® is approved only for patients with early-stage cognitive impairment, including mild cognitive impairment (MCI) due to AD or mild AD. Estimates are that approximately 1.5 million Americans will be candidates for on-label therapy. Depending on severity, treatment may be temporarily held.
What is ARIA?
ARIA stands for amyloid-related imaging abnormalities.
ARIA can clinically present as:
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headaches
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confusion
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nausea
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visual disturbance
When is risk the highest?
Risk is highest in the initial treatment period, at high dose, and in those with APOE ε4 homozygote carrier status.
What if the patient develops symptoms of ARIA?
If a patient develops these symptoms, treatment is temporarily held until a follow-up MRI demonstrates resolution of ARIA-E and stability of ARIA-H. ARIA-E is temporary and typically resolves over the course of weeks to months. Talk to your doctor if you have any further ARIA related questions.
Read more on this offering from our very own Dr. Suzie Bash, MD and Dr. Lawrence Tanenbaum, MD here.
