Lecanemab: Appropriate Use Recommendations by Korean Dementia Association

Area of Science:

• Neurology
• Pharmacology
• Biotechnology

Background:

• Alzheimer's disease (AD) is a progressive neurodegenerative disorder.
• Amyloid-beta plaques are a key pathological hallmark of AD.
• Early intervention is crucial for managing cognitive decline in AD.

Purpose of the Study:

• To provide clinical recommendations for the appropriate use of lecanemab in Korea.
• To guide healthcare professionals in patient selection, administration, and monitoring of lecanemab.
• To ensure the safe and effective application of this anti-amyloid therapy.

Main Methods:

• Development of clinical guidelines by the Korean Dementia Association.
• Identification of patient eligibility criteria, including amyloid biomarker confirmation.
• Establishment of protocols for pre-administration testing (e.g., apolipoprotein E genotyping) and magnetic resonance imaging (MRI) monitoring.
• Outline of administration procedures and management of adverse events like infusion-related reactions and ARIA.

Main Results:

• Lecanemab is recommended for patients with mild cognitive impairment (MCI) or mild dementia due to AD with positive amyloid biomarkers.
• Contraindications include severe hypersensitivity and inability to undergo MRI.
• Apolipoprotein E genotyping is advised for ARIA risk prediction, with regular MRI monitoring during treatment.
• Infusion-related reactions are common adverse events requiring management.
• Caution is advised when co-administering with anticoagulants or tissue plasminogen activator due to hemorrhage risk.

Conclusions:

• These recommendations facilitate the appropriate and safe use of lecanemab for early AD in Korea.
• Comprehensive assessment of patient suitability, risk factors, and monitoring is essential.
• Adherence to guidelines supports optimal therapeutic outcomes and patient safety.