What Is Leqembi?
Leqembi (lecanemab) is an amyloid beta-directed antibody, a new drug developed to treat Alzheimer’s.
Amyloid beta is a protein found in the brain and is thought to play a role in the development of Alzheimer's disease. Amyloid beta is a fragment of an amyloid precursor protein (APP), which is found in nerve cells in the brain. In Alzheimer's disease, amyloid beta proteins clump together to form plaques in the brain, which are believed to damage nerve cells and contribute to the symptoms of the disease. The accumulation of amyloid beta in the brain is one of the main hallmarks of Alzheimer's disease and is the target of many current research studies and drug development efforts.
When Is Leqembi Used?
Leqembi drug is indicated when patients suffer mild cognitive impairment or mild dementia stage of Alzheimer’s, and this is a population in which treatment was initiated in clinical trials. Currently, there is no safety or effectiveness data on using the drug for treatment at earlier or later stages of Alzheimer's than the one above-mentioned.
Alzheimer's disease is a progressive brain disorder that affects memory, thinking, and behavior. Usual symptoms of Alzheimer's include memory loss, difficulty with language, disorientation, mood swings, loss of motivation, and changes in behavior. The exact cause of Alzheimer's is unknown, but it is thought to be a combination of genetic, lifestyle, and environmental factors. There is currently no cure for Alzheimer's, but treatments are available to help manage symptoms. Leqembi drug is also used to help manage symptoms.
Approval of Leqembi is based on a reduction in amyloid beta plaques observed in patients treated with it.
Who Developed Leqembi?
Leqembi was developed as a result of a strategic research alliance between Eisai and BioArctic. Eisai is a Japanese pharmaceutical company based in Tokyo. Bioarctic AB is a Swedish pharmaceutical research company it develops medicines and diagnostic aids for diseases of the central nervous system, such as Alzheimer's disease and Parkinson's disease. Bioarctic and Eisai have a long-term collaboration going back to 2005.
How Does Leqembi Work? What Is The Mechanism of Action?
The generic name for Leqembi is lecanemab. Lecanemab is a humanized immunoglobulin gamma 1 (IgG1) monoclonal antibody directed against aggregated soluble and insoluble forms of amyloid beta. The accumulation of amyloid beta plaques in the brain is a defining pathophysiological feature of Alzheimer’s disease. Leqembi reduces amyloid-beta plaque being is the mechanism of action in the case of Alzheimer’s.
Important Information To Know For Patients Taking Leqembi
The main side effect of taking Leqembi (lecanemab) is reported brain swelling which scientifically described as ARIA which stands for Amyloid Related Imaging Abnormalities.
As already mentioned, ARIA is usually seen as temporary swelling in areas of the brain that usually resolves over time and most people with this type of swelling in the brain do not get symptoms, however some people may have symptoms, such as:
Headache
Confusion
Dizziness
Vision changes
Nausea
Difficulty walking
Seizures
In order to track unwanted side effects, your healthcare provider will preform MRI scans before and during your treatment with Leqembi to check you for ARIA.
Also, important to note that some individuals have a genetic risk factor homozygous apolipoprotein E gene (APOE) carriers that may cause an increased risk for ARIA. If there is a genetic risk factor, it is import to talk to your healthcare provide regarding pharmacogenoetic testing to evaluate the genetic risk.
The APOE gene encodes for a protein called apolipoprotein E. apolipoprotein E is involved in cholesterol metabolism and the transport of fats in the body. The APOE gene has three common variants, known as alleles: E2, E3, and E4. The APOE gene has been shown to play a role in the development of brain swelling, also known as cerebral edema. Studies have found that individuals with the E4 variant of the APOE gene may be at a higher risk for developing brain swelling in response to certain types of brain injury, such as traumatic brain injury (TBI) or stroke. This may be due to the fact that the E4 variant of the APOE protein is less effective at clearing lipids from the brain, leading to the accumulation of fats and fluid in the brain tissue.
Furthermore, the E4 variant of the APOE gene has been linked to an increased risk of neurodegenerative disorders such as Alzheimer's disease, which also results in brain swelling.