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Leqembi

lecanemab-irmb
Used for Alzheimer's Disease
Used for Alzheimer's Disease

Leqembi (lecanemab or lecanemab-irmb) is an injectable monoclonal antibody that's used to treat people with mild Alzheimer's disease. It was approved by the FDA in January 2023 through the accelerated approval pathway. But as of July 2023, the medication has full FDA approval to treat Alzheimer's disease. Leqembi (lecanemab) is infused into a vein by a trained healthcare provider once every 2 weeks. Common side effects include infusion-related reactions and headache. Note that Leqembi (lecanemab) isn't a cure for Alzheimer's disease.

Reviewed by:
reviewer
Kristianne Hannemann, PharmD
reviewer
Allison Gourley, PharmD
Last reviewed on January 25, 2024
BasicsSide effectsPros & consPharmacist tipsFAQsWarningsDosageAlternativesLatest newsImagesReferencesPricesMedicare
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What is Leqembi (lecanemab)?

What is Leqembi (lecanemab) used for?

  • Alzheimer’s disease (mild cognitive impairment)

How Leqembi (lecanemab) works

Leqembi (lecanemab) is an amyloid beta-directed monoclonal antibody. This means that it targets a protein in the brain called amyloid beta (also called beta-amyloid). These proteins clump together in Alzheimer's disease to form plaques that can be toxic for your brain cells.

Leqembi (lecanemab) works to lessen the buildup of these plaques in the brain. Some researchers believe that lessening amyloid beta plaques in the brain can slow Alzheimer's from getting worse. But more studies are needed to confirm this effect.

Drug Facts

Common BrandsLeqembi
Drug ClassAmyloid beta-directed antibody
Controlled Substance ClassificationNot a controlled medication
Generic StatusNo lower-cost generic available
AvailabilityPrescription only

More on Leqembi (lecanemab) essentials

Lecanemab-Irmb: daughter father paperwork 1394729033

What to Know About Lecanemab (Leqembi), a New Medication for Early Alzheimer's Disease

Written by Joshua Murdock, PharmD, BCBBS
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What are the side effects of Leqembi (lecanemab)?

The following side effects may get better over time as your body gets used to the medication. Let your healthcare provider know immediately if you continue to experience these symptoms or if they worsen over time.

Common Side Effects

  • Infusion-related reaction (26%)
  • Brain bleeding (14%)
  • Brain swelling (13%)
  • Headache (11%)

Other Side Effects

  • Nausea or vomiting
  • Rash
  • Irregular heart rhythm
  • Low white blood cell count

Serious Side Effects

Contact your healthcare provider immediately if you experience any of the following.
  • Brain swelling or bleeding: headache, nausea, confusion, dizziness, vision changes, trouble communicating, weakness, trouble walking, seizure
  • Infusion-related reaction: trouble breathing, dizziness, nausea, fever, chills, muscle ache, joint pain, pounding chest
  • Severe allergic reaction: swelling in the face or throat, tightening of the throat, chest tightness, trouble breathing

Source: DailyMed

The following side effects have also been reported

Side effects that you should report to your care team as soon as possible:

  • Allergic reactions or angioedema—skin rash, itching or hives, swelling of the face, eyes, lips, tongue, arms, or legs, trouble swallowing or breathing
  • Headache, worsening confusion, dizziness, change in vision, nausea, seizures
  • Infusion reactions—chest pain, shortness of breath or trouble breathing, feeling faint or lightheaded

Side effects that usually do not require medical attention (report these to your care team if they continue or are bothersome):

pros-and-cons

Pros and cons of Leqembi (lecanemab)

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Pros

Given once every 2 weeks

Lessens amyloid beta plaques in the brain

Can slow down worsening of Alzheimer's disease in people with mild symptoms

No known interactions with other medications

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Cons

Brand-name medication only

Only available as an IV infusion that's given by a healthcare provider

Must get MRI scans before and during treatment

Not studied in people with moderate or severe Alzheimer's disease

pharmacist-tips

Pharmacist tips for Leqembi (lecanemab)

pharmacist

  • Make sure to put your Leqembi (lecanemab) infusions and MRI appointments on a calendar so you don't miss any doses. Have a caregiver help you keep track of your appointments.

    • If you miss an appointment for your Leqembi (lecanemab) infusion, call your provider to schedule your next dose as soon as possible.

      • Bring a book or something to do to help pass the time during your Leqembi (lecanemab) infusion. Each infusion takes about 1 hour, but it can sometimes take longer depending on whether you have reactions to the infusion.

        • Tell your provider if you're taking medications that help lower the risk for blood clots (e.g., aspirin, blood thinners). Your provider will want to monitor you more closely for possible bleeding problems in your brain while you're taking Leqembi (lecanemab).

          faqs

          Frequently asked questions about Leqembi (lecanemab)

          Will Leqembi (lecanemab) cure my Alzheimer's disease?
          No. But Leqembi (lecanemab) might be able to slow it down. Clinical studies showed that Leqembi (lecanemab) can lessen the buildup of toxic proteins in the brain called amyloid beta plaques in people with mild Alzheimer's disease. This is thought to be responsible for slowing down the worsening of symptoms due to Alzheimer's disease.
          How well does Leqembi (lecanemab) work?
          In an 18-month study of 1,795 people with Alzheimer's disease, researchers found that those who were taking Leqembi (lecanemab) did better on some memory, thinking, and language tests than those who didn't take the medication. The study participants who took Leqembi (lecanemab) also had less amyloid plaques. What's more, people who took Leqembi (lecanemab) had an average 27% slowing of disease progression compared to those who took placebo. Keep in mind that Leqembi (lecanemab) has only been studied in people with mild (early stage) Alzheimer's disease.
          Who makes Leqembi (lecanemab)?
          Leqembi (lecanemab) is manufactured by a pharmaceutical company called Eisai.
          How is Leqembi (lecanemab) administered?
          Leqembi (lecanemab) is given as an infusion through a vein by a trained healthcare provider once every 2 weeks. The infusion typically takes 1 hour, but can take longer if you have any infusion-related reactions.
          Does Leqembi (lecanemab) cause swelling in the brain?
          One possible side effect of Leqembi (lecanemab) is amyloid related imaging abnormalities, or ARIA. This side effect is usually seen on brain imaging scans called MRIs. It can look like swelling or spots of bleeding in the brain. In studies, about 13% of people who took the medication had some swelling in the brain. Before you can start Leqembi (lecanemab), you'll need to have had a recent MRI within the past year. Once you start treatment, you'll need an MRI before the 5th, 7th, and 14th infusion. These MRI scans help your provider check for ARIA, since not everyone has symptoms from it. Tell your provider right away if you experience headache, confusion, nausea, dizziness, trouble walking, vision changes, or seizures. You'll probably need another MRI to check for ARIA.
          How long will my Leqembi (lecanemab) infusion take?
          Each Leqembi (lecanemab) infusion takes about 1 hour. During your infusion, your provider will watch for any signs of reactions like flu-like symptoms, dizziness, or trouble breathing. If these reactions happen, your provider might slow down the infusion to help with these symptoms. Your provider might also recommend that you take certain medications before your next infusions to help prevent or lessen the severity of the reactions. These medications can include antihistamines, NSAIDs, and steroids.
          What's the difference between Leqembi (lecanemab) and Aduhelm (aducanumab)?
          Both Leqembi (lecanemab) and Aduhelm (aducanumab) are used to treat mild Alzheimer's disease. Studies show that they can both remove amyloid beta plaques in the brain. Studies for Leqembi suggest that it might help slow the worsening of Alzheimer's. But studies for Aduhelm were stopped early before researchers could see its effects on slowing down the disease. What's more, Aduhelm is approved by the FDA under the accelerated approval pathway, which means that the manufacturer needs to continue researching the medication to make sure it's effective. Leqembi, though, has full FDA approval. One other difference is that Leqembi is given every other week and Aduhelm is given once a month. Speak with your provider to learn more about the two medications.
          When was Leqembi (lecanemab) approved?
          Leqembi (lecanemab) received FDA approval in January 2023 under the accelerated approval pathway, with the requirement of additional research to confirm its effectiveness. The medication got a full FDA approval in June 2023 when study results showed that it worked well to slow cognitive decline over 18 months.
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          What are the risks and warnings for Leqembi (lecanemab)?

          Leqembi (lecanemab) can cause some serious health issues. This risk may be even higher for certain groups. If this worries you, talk to your doctor or pharmacist about other options.

          risk-warning

          Amyloid related imaging abnormalities (ARIA)

          • Risk factors: Being a carrier of the apolipoprotein E ε4 (ApoE ε4) gene

            Leqembi (lecanemab) can cause a side effect called amyloid related imaging abnormalities (ARIA). These abnormalities are typically seen on an MRI scan as swelling or areas of bleeding in the brain.

            ARIA most commonly happens early in treatment (within the first 7 doses), but can happen at anytime, and you can have more than one episode. ARIA can also happen to anyone, but the risk appears to be higher for those with the ApoE ε4 gene. There's a test available to see if you have this gene.

            Make sure to check with your provider before you start taking any new medications. Certain medications like aspirin or clopidogrel (Plavix) might raise your risk of bleeding in the brain.

            Most people with ARIA don't notice any symptoms, so you'll need to get MRI scans done before and during treatment to watch out for it. If you do have symptoms, they tend to go away over time. But some can be more serious and rarely life threatening. Contact your provider right away if you have a headache, vision changes, dizziness, nausea, trouble walking, or a seizure.

            risk-warning

            Infusion-related reactions

            Leqembi (lecanemab) can cause infusion-related reactions, which can include chills, muscle or joint pain, nausea, vomiting, and changes in blood pressure. These reactions are mostly mild, but some can be serious. In studies, most reactions happened with the first infusion.

            Tell your provider if you feel unwell, have trouble breathing, or feel like your chest is pounding during your Leqembi (lecanemab) infusion. Your provider might slow down the infusion. But in some cases, your provider might need to stop the infusion altogether. If you have an infusion-related reaction, your provider might give you medications for you to take before your next dose to lower your chance of having another reaction.

            risk-warning

            Allergic reactions

            In some rare cases, Leqembi (lecanemab) can cause serious allergic reactions, including severe swelling and anaphylaxis. Get medical help right away if you notice hives, swelling in your face or throat, or trouble breathing.

            dosage

            Leqembi (lecanemab) dosage forms

            Typical dosing for Leqembi (lecanemab)

            Leqembi (lecanemab) is given as an intravenous (IV) infusion by a healthcare provider.

            The typical dose is 10 mg/kg of body weight given once every 2 weeks.

            alternatives

            What are alternatives to Leqembi (lecanemab)?

            There are a number of medications that your doctor can prescribe in place of Leqembi (lecanemab). Compare a few possible alternatives below.
            Leqembi (lecanemab)
            Used for:

            • Alzheimer’s disease (mild cognitive impairment)

            View Prices
            Aduhelm (aducanumab)
            Used for:
            View Prices
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            Leqembi (lecanemab) images

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            References

            Best studies we found

            Abushakra, S., et al. (2023). Prevalence of amyloid-related imaging abnormalities in APOE4/4 homozygotes with early Alzheimer’s disease: Baseline findings from ongoing clinical trials of oral anti-amyloid agent ALZ-801 (valiltramiprosate) (P5-6.003). Neurology.

            Biogen Inc. (2022). Eisai presents full results of lecanemab phase 3 confirmatory clarity ad study for early Alzheimer’s disease at clinical trials on Alzheimer’s disease (Ctad) conference. PRNewswire.

            Eisai Co., Ltd. (2023). FDA grants traditional approval for Leqembi® (lecanemab-irmb) for the treatment of Alzheimer’s disease.

            View All References (10)

            Eisai Inc. (2024). Leqembi- lecanemab injection, solution [package insert]. DailyMed.

            Knopman, D. S., et al. (2020). Failure to demonstrate efficacy of aducanumab: An analysis of the EMERGE and ENGAGE trials as reported by Biogen, December 2019. Alzheimer's & Dementia.

            National Institute on Aging. (2024). What happens to the brain in Alzheimer's disease?

            Söderberg, L., et al. (2022). Lecanemab, aducanumab, and gantenerumab — Binding profiles to different forms of amyloid-beta might explain efficacy and side effects in clinical trials for Alzheimer’s disease. Neurotherapeutics.

            Sperling, R. A., et al. (2011). Amyloid-related imaging abnormalities in amyloid-modifying therapeutic trials: Recommendations from the Alzheimer's Association Research Roundtable Workgroup. Alzheimer's & Dementia.

            U.S. Food and Drug Administration. (2021). Aducanumab (marketed as Aduhelm) information.

            U.S. Food and Drug Administration. (2023). FDA converts novel Alzheimer’s disease treatment to traditional approval.

            U.S. Food and Drug Administration. (2023). FDA converts novel Alzheimer’s disease treatment to traditional approval.

            U.S. Food and Drug Administration. (2023). FDA grants accelerated approval for Alzheimer’s disease treatment.

            van Dyck, C. H., et al. (2022). Lecanemab in early Alzheimer’s disease. The New England Journal of Medicine.

            GoodRx Health has strict sourcing policies and relies on primary sources such as medical organizations, governmental agencies, academic institutions, and peer-reviewed scientific journals. Learn more about how we ensure our content is accurate, thorough, and unbiased by reading our editorial guidelines.
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