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Lecanemab, Donanemab, and Emerging Disease Modifying Therapies for Alzheimer Disease: Clinical Evidence and Primary Care Implications in Canada
Sharma, Geetika. International Journal of Science and Research Archive, 2025-10-31
Topic: Amyloid, tau and blood-test diagnosis
Monoclonal antibodies such as lecanemab and donanemab show reduction in amyloid plaque and slowing of cognitive and functional decline (modest) in early AD (mild cognitive impairment or mild dementia). In contrast, Aducanumab while initially promising ended up showing mixed results and due to inconsistent clinical outcomes, it is not approved by Health Canada at present. Tau‑targeting and anti‑inflammatory agents are under investigation but have not yet demonstrated definitive benefit. Key risks include amyloid‑related imaging abnormalities (ARIA), infusion reactions, cost, and lack of data for long term safety. Canadian health system challenges include lack of access to biomarker testing and imaging, Lack of healthcare specialists, and reimbursement frameworks. Using DMTs in the early phases of AD offers significant promise in altering disease progression. However, Family Physicians needs to thoroughly evaluate the risk to benefit ratio, ensure careful patient selection, and work in close collaboration with specialists. Furthermore, ensuring the healthcare system is ready— with access to proper testing facilities, coverage models, and support systems—is essential for the safe and equitable implementation of these therapies. Key points Monoclonal antibodies (lecanemab, donanemab) are the most advanced DMTs in AD at present with evidence that shows slight slowing in clinical decline in early AD patients. Risks associated to the treatment like ARIA etc. requires biomarker confirmation which is not readily available throughout Canada yet. Family Physicians and Canadian Healthcare System play a crucial role in selection of patient, their monitoring, treatment coverage and testing.
Key findings
- Monoclonal antibodies such as lecanemab and donanemab show reduction in amyloid plaque and slowing of cognitive and functional decline (modest) in early AD (mild cognitive impairment or mild dementia).
- In contrast, Aducanumab while initially promising ended up showing mixed results and due to inconsistent clinical outcomes, it is not approved by Health Canada at present.
- Tau‑targeting and anti‑inflammatory agents are under investigation but have not yet demonstrated definitive benefit.
- Key risks include amyloid‑related imaging abnormalities (ARIA), infusion reactions, cost, and lack of data for long term safety.
- Canadian health system challenges include lack of access to biomarker testing and imaging, Lack of healthcare specialists, and reimbursement frameworks.
Why it matters
Lecanemab and donanemab modestly slow cognitive and functional decline in early Alzheimer disease, while aducanumab showed mixed results and is not approved by Health Canada. Tau-targeting and anti-inflammatory agents are still under investigation and have not yet shown definitive benefit.
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Study details
- Study designnarrative review
- Evidence strengthHigh
How this study scored 45/100
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 journal's citation record, times cited, citations per year, impact for its field and year, still being cited, senior author's track record, institution's track record and multi-centre collaboration, so those were left out: it earned 29 of the 64 points we could judge it on, which is 45 out of 100.
| Component | Points | Why |
|---|---|---|
| Journal tier | 7 / 10 | Tier 3 — peer-reviewed journal (International Journal of Science and Research Archive) |
| Journal's citation record | — / 4 | No journal record from OpenAlex — left out of this score |
| Study design | 0 / 12 | Design recorded as “narrative review”, which our rubric does not rank (not stated in the record — scored 0) |
| Strength of evidence | 5 / 5 | Rated “high” in our summary |
| Peer-review validation | 10 / 10 | Peer-reviewed. Published as an article in a named peer-reviewed journal. |
| How recent | 4 / 5 | 2025 — within 3 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 | — / 7 | No citation count (not found in OpenAlex) — left out of this score |
| Citations per year | — / 5 | No citation count or no year — left out of this score |
| Impact for its field and year | — / 6 | No field-weighted citation impact (OpenAlex has none yet) — left out of this score |
| Cited by studies here | 0 / 6 | No other study in this library cites it |
| Still being cited | — / 4 | No yearly citation counts — left out of this score |
| Senior author's track record | — / 4 | Senior author's record not available — left out of this score |
| Institution's track record | — / 3 | No institution listed in OpenAlex — left out of this score |
| Multi-centre collaboration | — / 3 | Institutions not listed — left out of this score |
| Indexed in PubMed | 1 / 2 | Not in PubMed, but has a DOI |
| Free to read | 2 / 2 | Free to read |
| Points | 29 / 64 | Scored on 12 of 20 parts. We have no data for the rest, so they are left out: 29 of the 64 points we could judge it on is 45 out of 100. |
| Total | 45 / 100 | — |
What each of these 20 components measures, and what this score is not →
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APA 7th
Sharma, G. (2025). Lecanemab, Donanemab, and Emerging Disease Modifying Therapies for Alzheimer Disease: Clinical Evidence and Primary Care Implications in Canada. International Journal of Science and Research Archive. https://doi.org/10.5281/zenodo.17615266
Vancouver
Sharma G. Lecanemab, Donanemab, and Emerging Disease Modifying Therapies for Alzheimer Disease: Clinical Evidence and Primary Care Implications in Canada. International Journal of Science and Research Archive. 2025. doi:10.5281/zenodo.17615266.
BibTeX
@article{sharma2025-08ace6f7,
author = {Sharma, Geetika},
title = {{Lecanemab, Donanemab, and Emerging Disease Modifying Therapies for Alzheimer Disease: Clinical Evidence and Primary Care Implications in Canada}},
journal = {International Journal of Science and Research Archive},
year = {2025},
doi = {10.5281/zenodo.17615266},
url = {https://doi.org/10.5281/zenodo.17615266}
}