Neurologists in the United States have a strong interest in prescribing the new Alzheimer’s disease drug Leqembi (lecanemab), with the majority of 73 specialists surveyed saying they would prescribe the treatment if the government fully approves it.
The Food and Drug Administration in January granted accelerated approval for Leqembi, a monoclonal antibody shown to reduce measures of cognitive decline in patients with early Alzheimer’s. Medicare coverage of drugs in its class is limited to clinical trials, however, and the Centers for Medicare & Medicaid Services has said it may reconsider wider coverage if the FDA grants it traditional approval.
The March 2023 survey, from Spherix Global Insights, found that “a healthy proportion” of neurologists had already begun prescribing Leqembi within a month of commercial availability. But most have chosen to wait and see the FDA’s decision when reviews the drugmakers’ request for traditional approval on July 6, the analysts reported.
If traditional FDA approval is granted, nearly all of the surveyed specialists said they planned to prescribe the treatment, mostly within the year following the greenlight, Spherix reported.
The survey also showed that despite all the cautious enthusiasm, concerns remain. Many survey respondents said that the drug’s possible side effects would likely limit the patient pool.
Leqembi targets amyloid brain plaques associated with Alzheimer’s disease. Potential adverse effects include amyloid-related imaging abnormalities (ARIA). Patients who take the drug will need to receive serial MRI scans in the first few months of treatment, they noted.
“Every time a patient has a complaint, you’re going to be saying, ‘Do I need to scan them? Do I need the MRI? Is it ARIA?'” one physician noted in their survey response.