Dementia and Neurocognitive Disorders (대한치매학회지)

Korean Dementia Association (대한치매학회)
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Lecanemab: Appropriate Use Recommendations by Korean Dementia Association

  • Kee Hyung Park (Department of Neurology, Gachon University Gil Medical Center, Gachon University College of Medicine) ;
  • Geon Ha Kim (Department of Neurology, Ewha Womans University Mokdong Hospital, Ewha Womans University College of Medicine) ;
  • Chi-Hun Kim (Department of Neurology, Hallym University Sacred Heart Hospital, Hallym University College of Medicine) ;
  • Seong-Ho Koh (Department of Neurology, Hanyang University Guri Hospital, Hanyang University College of Medicine) ;
  • So Young Moon (Department of Neurology, Ajou University Hospital, Ajou University School of Medicine) ;
  • Young Ho Park (Department of Neurology, Seoul National University Bundang Hospital, Seoul National University College of Medicine) ;
  • Sang Won Seo (Department of Neurology, Samsung Medical Center, Sungkyunkwan University School of Medicine) ;
  • Bora Yoon (Department of Neurology, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea) ;
  • Jae-Sung Lim (Department of Neurology, Asan Medical Center, University of Ulsan College of Medicine) ;
  • Byeong C. Kim (Department of Neurology, Chonnam National University Hospital, Chonnam National University Medical School) ;
  • Hee-Jin Kim (Department of Neurology, Hanyang University Hospital, Hanyang University College of Medicine) ;
  • Hae Ri Na (Department of Neurology, Bobath Memorial Hospital) ;
  • YongSoo Shim (Department of Neurology, Eunpyeong St. Mary's Hospital, College of Medicine, The Catholic University of Korea) ;
  • YoungSoon Yang (Department of Neurology, Soonchunhyang University Cheonan Hospital, Soonchunhyang University College of Medicine) ;
  • Chan-Nyoung Lee (Department of Neurology, Korea University Anam Hospital, Korea University College of Medicine) ;
  • Hak Young Rhee (Department of Neurology, Kyung Hee University Hospital at Gangdong, Kyung Hee University College of Medicine) ;
  • San Jung (Department of Neurology, Hallym University Kangnam Sacred Heart Hospital, Hallym University College of Medicine) ;
  • Jee Hyang Jeong (Department of Neurology, Ewha Womans University Seoul Hospital, Ewha Womans University College of Medicine) ;
  • Hojin Choi (Department of Neurology, Hanyang University Guri Hospital, Hanyang University College of Medicine) ;
  • Dong Won Yang (Department of Neurology, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea) ;
  • Seong Hye Choi (Department of Neurology, Inha University Hospital, Inha University College of Medicine)
  • Received : 2024.09.30
  • Accepted : 2024.10.23
  • Published : 2024.10.31
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Abstract

Lecanemab (product name Leqembi®) is an anti-amyloid monoclonal antibody treatment approved for use in Korea for patients with mild cognitive impairment (MCI) or mild dementia due to Alzheimer's disease. The Korean Dementia Association has created recommendations for the appropriate use of lecanemab to assist clinicians. These recommendations include selecting patients for administration, necessary pre-administration tests and preparations, administration methods, monitoring for amyloid related imaging abnormalities (ARIA), and communication with patients and caregivers. Lecanemab is recommended for patients with MCI or mild dementia who confirmed positive amyloid biomarkers, and should not be administered to patients with severe hypersensitivity to lecanemab or those unable to undergo magnetic resonance imaging (MRI) evaluation. To predict the risk of ARIA before administration, apolipoprotein E genotyping is conducted, and regular brain MRI evaluations are recommended to monitor for ARIA during treatment. The most common adverse reactions are infusion-related reactions, which require appropriate management upon occurrence. Additional caution is needed when co-administering with anticoagulants or tissue plasminogen activator due to the risk of macrohemorrhage. Clinicians should consider the efficacy and necessary conditions for administration, as well as the safety of lecanemab, to make a comprehensive decision regarding its use.

Keywords

Acknowledgement

This work was prepared by the AUR task force team of the Korean Dementia Association and the JOY-ALZ (Korean JOint RegistrY for ALZheimer's Treatment and Diagnostics) project.

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