The European Medicines Agency (EMA) has recommended conditional approval for lecanemab, marketed as Leqembi, as the first treatment in the EU aimed at slowing the progression of Alzheimer's disease. This marks a significant milestone, offering a potential disease-modifying therapy for patients in the early stages of the condition.
The recommendation specifies that lecanemab is intended for patients with mild cognitive impairment or early-stage Alzheimer's who have one or no copies of the ApoE4 gene. This restriction is due to a higher risk of side effects, including amyloid-related imaging abnormalities (ARIA) such as swelling and bleeding in the brain, in individuals with two copies of the ApoE4 gene.
The EMA's decision comes after an initial rejection of the application, citing concerns about the balance between benefits and risks. However, the agency now concludes that, for the specified patient subgroup, "the benefits of Leqembi in slowing down progression of symptoms of the disease are greater than its risks." Patients receiving lecanemab will require bi-weekly infusions and regular monitoring to detect and manage potential side effects.
Lecanemab, developed by Eisai and Biogen, is a monoclonal antibody designed to target and remove amyloid plaques in the brain, a hallmark of Alzheimer's disease. Clinical trials have demonstrated a modest slowing of cognitive decline in early-stage patients. The drug received accelerated approval in the United States in 2023.
Currently, available Alzheimer's drugs primarily address the symptoms of the disease, offering temporary relief but not altering the underlying disease course. Lecanemab represents a new approach by targeting the underlying pathology of Alzheimer's.
The European Commission will now review the EMA's recommendation and make a final decision regarding market authorization for lecanemab in the EU. If approved, lecanemab could offer a valuable new treatment option for a subset of Alzheimer's patients, addressing a significant unmet medical need.
