Lecanemab is a Health Canada approved therapy used to treat mild memory or thinking problems (mild cognitive impairment) or mild dementia caused by Alzheimer’s’ disease. It is a type of medicine called a disease modifying therapy (DMT), a class of drug that works to slow down the changes in the brain that cause symptoms to get worse over time.
Lecanemab is given intravenously every two weeks. After approximately 18 months of therapy, the schedule may be changed to once every four weeks, or it may be stopped earlier if needed.
There are strict eligibility requirements for those who can receive lecanemab. It is estimated that only around 10 per cent of patients assessed for cognitive impairment will meet criteria for the therapy. Your doctor will decide if you qualify based on your diagnosis, medical history, and test results (blood and imaging tests).
There are three core eligibility components for lecanemab treatment:
- Stage of disease: Patients must have mild cognitive impairment or mild dementia due to Alzheimer’s disease (i.e., early Alzheimer’s dementia).
- Genotype: Patients who carry two copies of the APOE ε4 gene cannot receive the medication due to a significantly higher risk of serious side effects, including amyloid-related imaging abnormalities (ARIA).
- Diagnostic confirmation: Amyloid pathology must be confirmed via PET or CSF testing, and patients must have a recent baseline MRI prior to treatment initiation.
Certain brain imaging findings, use of certain medications or serious medical comorbidities may disqualify patients from being eligible to receive the treatment.
It is important for patients to understand that lecanemab has a risk of serious side effects known as amyloid-related imaging abnormalities (ARIA), which can include brain swelling and bleeding in the brain. Eligible patients require close medical monitoring, including regular MRI scans, to ensure safety throughout treatment.
Lecanemab is given through intravenous infusion into a vein in the arm every two weeks.
Each infusion takes approximately one hour.
Infusions are closely monitored. Most side effects are mild and can easily be managed by a nurse. A doctor will intervene if a side effect is considered severe.
At this time, lecanemab is only available through self-payment (out-of-pocket), as it is not currently available through publicly funded coverage or through private insurance carriers in Canada. This means that, for now, people who qualify for the medication must pay for it themselves.
Canada’s Drug Agency (CDA-AMC) is now in the process of deciding if lecanemab will be paid for by the government. If approved, each province and territory goes through the process to decide on pricing and coverage.
In Canada, it can take up to two years after regulatory approval for new medicines to become publicly covered, while people with private or extended benefits often gain access much sooner.
The
Alzheimer Society of Canada urges faster, more coordinated reimbursement processes so that approval translates into timely, equitable access for all Canadians.
Patients of the Bruyère Health Memory Clinic who are eligible and interested will be referred to a patient support program that will link them to a community infusion centre to receive the treatment closer to home.
The Bruyère Health Memory Clinic is also working with partners across the region to create a referral stream to identify eligible and interested patients, supporting equitable access in our region.
Tools to determine eligibility, support clinical decision making, and referrals are all under development.