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Neurodegeneration

How safe is clinic lecanemab in practice?

Paczynski M, Hofmann A, Posey Z, et al. · JAMA neurology · 2025

Open access · cc by · source: Europe PMC

Among 234 memory-clinic patients on lecanemab, infusion reactions (37%) and ARIA (22%) were common but generally manageable; mild dementia had much higher symptomatic ARIA.

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Study at a glance

Design
Cohort — Retrospective consecutive case series of specialty-clinic lecanemab initiations
N
N=234 · Patients with early symptomatic AD receiving ≥1 infusion
Population
Early symptomatic Alzheimer disease patients at Washington University Memory Diagnostic Center
Outcome
Infusion reactions, ARIA (including symptomatic), and treatment withdrawal

Structured fields used in claim comparison tables when every cited study has a complete layer.

Key findings

IRR 37%; ARIA 22% (ARIA-E 15%, isolated ARIA-H 6.7%); symptomatic ARIA 5.7% overall but 27% in mild dementia vs 1.8% in MCI/very mild; 9.8% withdrew (4.3% for ARIA); no macrohemorrhage/death.

Methodology

Reviewed consecutive lecanemab starts (Aug 2023–Oct 2024), dosing every 2 weeks, MRI monitoring, and adverse events through Dec 2024.

Limitations

Long-term efficacy vs placebo in this clinic sample, or risk under every eligibility exception.

How this study connects

Role on claims

Each row is a claim on a concept or method page where this paper supports, challenges, or qualifies the statement. Roles are hand-checked — not a model guess.

  • QualifiesAlzheimer’s and MCI markersconcept

    Brain multi-omics reveals multimodal AD molecular profiles including a severe cluster.

    Integrating transcriptomic/proteomic/metabolomic/lipidomic brain data yielded four multimodal profiles, including Knight-C4 with pronounced dysregulation and worse clinical features.

    Scope note — clinic anti-amyloid treatment experience — not a multi-omics subtype discovery

    Limits the claim's scope: a different population, assay, or outcome.

  • SupportsAlzheimer’s and MCI markersconcept

    Specialty clinics are delivering lecanemab with real-world workflow constraints.

    A specialty memory-clinic report on lecanemab treatment adds practice-level evidence beside biomarker/pathology marker papers.

    Evidence for the claim as stated.

History

When this study was placed

Dated entries from the concept change log — when this paper was added or removed as support, challenge, or qualifier on a claim.

  1. 2026-09-15

    Placed as a scope qualifier on Alzheimer’s and MCI markers

    Integrating transcriptomic/proteomic/metabolomic/lipidomic brain data yielded four multimodal profiles, including Knight-C4 with pronounced dysregulation and worse clinical features.

  2. 2026-09-15

    Placed as supporting evidence on Alzheimer’s and MCI markers

    A specialty memory-clinic report on lecanemab treatment adds practice-level evidence beside biomarker/pathology marker papers.

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