Lecanemab, Donanemab, and Emerging Disease Modifying Therapies for Alzheimer Disease: Clinical Evidence and Primary Care Implications in Canada

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 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

Read the original

• DOI: 10.30574/ijsra.2025.17.1.2929
• Original source →
• Free full text: International Journal of Science and Research Archive →

Full text: free to read — OpenAlex lists this copy as free to read: the link above (checked 6 Feb 1020).

@article{sharma2025-1b2f6657,
  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     = {10.30574/ijsra.2025.17.1.2929},
  url     = {https://doi.org/10.30574/ijsra.2025.17.1.2929}
}

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