Real‐world implementation of lecanemab in Korean patients at a tertiary memory clinic: Safety, ARIA risk, and early treatment patterns
Jaemin Shin, Sang‐Il Suh, Yu Jeong Park, Seungyun Lee, Jimin Kang, Eun Seong Lee, Hye Na Jung, Inseon Ryoo, Seongin Lee, Jae Seon Eo, Kyungmi Oh, Seong‐Beom Koh, Sung Hoon KangAbstract
INTRODUCTION
Lecanemab has demonstrated clinical efficacy in early Alzheimer's disease (AD), but real‐world data remain limited, particularly in Asian populations.
METHODS
We prospectively enrolled 127 patients across the AD continuum who initiated lecanemab at a tertiary memory clinic in Korea. Infusion‐related reactions (IRRs), amyloid‐related imaging abnormalities (ARIAs), and cognitive outcomes were evaluated through clinical assessments, serial magnetic resonance imaging (MRI), and longitudinal Mini‐Mental State Examination (MMSE) follow‐up.
RESULTS
Among 127 patients, 102 completed at least five infusions with follow‐up MRI. IRRs occurred in 27 (21.3%) patients, primarily during the first infusion. ARIAs occurred in 9 of 102 (8.8%), including ARIAs with edema in 4 (3.9%) and ARIA with hemorrhage in 7 (6.9%); most events were mild or asymptomatic. Higher microbleed burden and white matter hyperintensity were associated with increased ARIA risk. MMSE scores remained stable over 6 months.
DISCUSSION
In this prospective Korean cohort, lecanemab was generally well tolerated. Longer term controlled studies are needed to clarify cognitive outcomes.