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Lecanemab: Appropriate Use Recommendations
Jeffrey L. Cummings, L Apostolova, Gil D. Rabinovici, A Atri, Pau Aisen, S Greenberg, S Hendrix, D Selkoe, M Weiner, R.C. Petersen, Stephen Salloway. The Journal of Prevention of Alzheimer s Disease, 2023-03-22
Topic: Risk, prevention and care in population studies
Lecanemab (Leqembi®) is approved in the United States for the treatment of Alzheimer's disease (AD) to be initiated in early AD (mild cognitive impairment [MCI] due to AD or mild AD dementia) with confirmed brain amyloid pathology. Appropriate Use Recommendations (AURs) are intended to help guide the introduction of new therapies into real-world clinical practice. Community dwelling patients with AD differ from those participating in clinical trials. Administration of lecanemab at clinical trial sites by individuals experienced with monoclonal antibody therapy also differs from the community clinic-based administration of lecanemab. These AURs use clinical trial data as well as research and care information regarding AD to help clinicians administer lecanemab with optimal safety and opportunity for effectiveness. Safety and efficacy of lecanemab are known only for patients like those participating in the phase 2 and phase 3 lecanemab trials, and these AURs adhere closely to the inclusion and exclusion criteria of the trials. Adverse events may occur with lecanemab including amyloid related imaging abnormalities (ARIA) and infusion reactions. Monitoring guidelines for these events are detailed in this AUR. Most ARIA with lecanemab is asymptomatic, but a few cases are serious or, very rarely, fatal. Microhemorrhages and rare macrohemorrhages may occur in patients receiving lecanemab. Anticoagulation increases the risk of hemorrhage, and the AUR recommends that patients requiring anticoagulants not receive lecanemab until more data regarding this interaction are available. Patients who are apolipoprotein E ε4 (APOE4) gene carriers, especially APOE4 homozygotes, are at higher risk for ARIA, and the AUR recommends APOE genotyping to better inform risk discussions with patients who are lecanemab candidates. Clinician and institutional preparedness are mandatory for use of lecanemab, and protocols for management of serious events should be developed and implemented. Communication between clinicians and therapy candidates or those on therapy is a key element of good clinical practice for the use of lecanemab. Patients and their care partners must understand the potential benefits, the potential harms, and the monitoring requirements for treatment with this agent. Culture-specific communication and building of trust between clinicians and patients are the foundation for successful use of lecanemab.
Why it matters
Gives recommendations to help clinicians use lecanemab, approved in the United States for early Alzheimer's disease with confirmed brain amyloid, as safely as possible in everyday practice. It covers monitoring for side effects such as amyloid related imaging abnormalities (ARIA) and infusion reactions, advises that patients who need anticoagulants not receive lecanemab until more data are available, and recommends APOE genotyping because APOE4 carriers are at higher risk for ARIA.
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How this study scored 51/100
Published in a peer-reviewed journal. Scored zero for study design, sample size, effect reported, studied in people and randomised / blinded because the record does not state it. We have no data on strength of evidence, senior author's track record and institution's track record, so those were left out: it earned 45 of the 88 points we could judge it on, which is 51 out of 100.
| Component | Points | Why |
|---|---|---|
| Journal tier | 7 / 10 | Tier 3 — peer-reviewed journal (The Journal of Prevention of Alzheimer s Disease) |
| Journal's citation record | 0 / 4 | The Journal of Prevention of Alzheimer s Disease: journal h-index 63 (OpenAlex, 2026-10-29) |
| Study design | 0 / 12 | No study design recorded — scores zero, not guessed (not stated in the record — scored 0) |
| Strength of evidence | — / 5 | No evidence rating recorded — left out of this score |
| Peer-review validation | 10 / 10 | Peer-reviewed. Published as an article in a named peer-reviewed journal. |
| How recent | 3 / 5 | 2023 — within 6 year(s) of the newest study here |
| Sample size | 0 / 4 | Participant count not stated — scores zero (not stated in the record — scored 0) |
| Effect reported | 0 / 3 | No effect size reported — scores zero (not stated in the record — scored 0) |
| Studied in people | 0 / 3 | Not stated whether this was studied in people — scores zero (not stated in the record — scored 0) |
| Randomised / blinded | 0 / 2 | No randomisation or blinding stated — scores zero (not stated in the record — scored 0) |
| Times cited | 6 / 7 | Cited 925 times (OpenAlex, 2026-10-10) |
| Citations per year | 5 / 5 | 185.0 citations a year over 5 year(s) since 2023 |
| Impact for its field and year | 6 / 6 | Cited 135.0× the average for papers of its field and year (OpenAlex FWCI) |
| Cited by studies here | 0 / 6 | No other study in this library cites it |
| Still being cited | 4 / 4 | Cited 855 times in 2024–2026 (2026 still in progress; OpenAlex) |
| Senior author's track record | — / 4 | OpenAlex's profile for last-listed author Stephen Salloway holds only 8 work(s), too few to judge a track record — left out of this score |
| Institution's track record | — / 3 | No institution listed in OpenAlex — left out of this score |
| Multi-centre collaboration | 0 / 3 | OpenAlex lists 0 institution(s) in 0 countries — scores zero (affiliation lists can be incomplete) |
| Indexed in PubMed | 2 / 2 | Indexed in PubMed (PMID 37357276) |
| Free to read | 2 / 2 | Free to read |
| Points | 45 / 88 | Scored on 17 of 20 parts. We have no data for the rest, so they are left out: 45 of the 88 points we could judge it on is 51 out of 100. |
| Total | 51 / 100 | — |
What each of these 20 components measures, and what this score is not →
Read the original
- DOI: 10.14283/jpad.2023.30
- PubMed: 37357276
- Original source →
- Free full text: The Journal of Prevention of Alzheimer s Disease →
Full text: free to read — OpenAlex lists this copy as free to read: the link above (checked 6 Feb 1020).
Cite this study APA, Vancouver, BibTeX · download .bib or .ris
Built from the record alzhub holds for this paper, not looked up. Volume, issue and page numbers are not held in the record. The record names 11 authors; APA and Vancouver show the first six, BibTeX and the downloads carry all of them. Check the citation against the original before you use it.
APA 7th
Cummings, J. L., Apostolova, L., Rabinovici, G. D., Atri, A., Aisen, P., Greenberg, S., et al. (2023). Lecanemab: Appropriate Use Recommendations. The Journal of Prevention of Alzheimer s Disease. https://doi.org/10.14283/jpad.2023.30
Vancouver
Cummings JL, Apostolova L, Rabinovici GD, Atri A, Aisen P, Greenberg S, et al. Lecanemab: Appropriate Use Recommendations. The Journal of Prevention of Alzheimer s Disease. 2023. doi:10.14283/jpad.2023.30. PMID: 37357276.
BibTeX
@article{cummings2023-37357276,
author = {Cummings, Jeffrey L. and Apostolova, L and Rabinovici, Gil D. and Atri, A and Aisen, Pau and Greenberg, S and Hendrix, S and Selkoe, D and Weiner, M and Petersen, R.C. and Salloway, Stephen},
title = {{Lecanemab: Appropriate Use Recommendations}},
journal = {The Journal of Prevention of Alzheimer s Disease},
year = {2023},
doi = {10.14283/jpad.2023.30},
pmid = {37357276},
url = {https://doi.org/10.14283/jpad.2023.30}
}