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Noa Bregman1,2,3,4,5, Talya Nathan4, Dror Shir4

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|December 25, 2025
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This study on Lecanemab for early Alzheimer's disease (AD) found a slight cognitive decline over six months, with fewer amyloid-related imaging abnormalities (ARIA) than expected. Real-world data supports Lecanemab's potential in managing AD.

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Area of Science:

  • Neurology
  • Pharmacology
  • Geriatrics

Background:

  • Alzheimer's disease (AD) is a progressive neurodegenerative disorder impacting patients and healthcare systems.
  • Lecanemab, an amyloid-beta targeting monoclonal antibody, is approved for early-stage AD, offering disease-modifying potential.
  • This study evaluates Lecanemab's real-world outcomes in early AD patients at Tel Aviv Medical Center.

Purpose of the Study:

  • To assess the demographic characteristics, treatment response, and safety of Lecanemab in early AD patients.
  • To analyze 6-month follow-up outcomes, including cognitive function and amyloid-related imaging abnormalities (ARIA).
  • To contribute real-world evidence for optimizing clinical practice with disease-modifying AD therapies.

Main Methods:

  • Prospective study of early AD patients treated with Lecanemab since November 2023.
  • Data collection included demographics, ApoE4 status, CSF and plasma biomarkers, and Mini-Mental State Examination (MMSE) scores.
  • Monitoring for ARIA and cognitive assessment at 6-month follow-up for patients completing the visit by January 2025.

Main Results:

  • 45 patients completed 6-month follow-up; mean age 73, 53% female, 51% ApoE4 carriers.
  • Mean MMSE score declined by 1.47 points (p=0.009) over 6 months; younger patients (<75) showed significant decline (p=0.007).
  • 15.5% developed asymptomatic ARIA-H; plasma p-tau181 correlated with baseline MMSE (r=-0.429, p=0.023).

Conclusions:

  • Lecanemab treatment showed a potential for cognitive preservation in early AD over 6 months.
  • The incidence of ARIA was lower than reported in clinical trials, suggesting a favorable safety profile in this cohort.
  • Real-world data is crucial for guiding clinical decisions regarding Lecanemab and other disease-modifying therapies for AD.