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Review
. 2023 Feb;32(2):89-94.
doi: 10.1080/13543784.2023.2178414. Epub 2023 Feb 28.

Lecanemab (BAN2401): an anti-beta-amyloid monoclonal antibody for the treatment of Alzheimer disease

Grace E Vitek  1 , Boris Decourt  2 , Marwan N Sabbagh  3
Affiliations
Review

Lecanemab (BAN2401): an anti-beta-amyloid monoclonal antibody for the treatment of Alzheimer disease

Grace E Vitek et al. Expert Opin Investig Drugs. 2023 Feb.

Abstract

Introduction: Nearly a dozen monoclonal antibodies (mAbs) directed against beta-amyloid (Aβ) have been developed for the treatment of Alzheimer disease (AD), and most of these mAbs are undergoing clinical trials. Newer mAbs have targeted more specific Aβ types. Lecanemab Eisai has a high affinity for large and soluble Aβ protofibrils. Data from phase 2 clinical trials have suggested the possibility of a robust efficacy signal and manageable risk of amyloid-related imaging abnormalities (ARIAs). Lecanemab is currently being studied in phase 3 trials.

Areas covered: This article briefly reviews mAbs that target Aβ in AD and discusses the biology, mechanism of action, and targets of lecanemab.

Expert opinion: mAbs that target Aβ are an important focus of therapeutic development for AD, with several soon to be considered for US Food and Drug Administration approval. The experience of aducanumab informs the development of other mAbs, such as lecanemab. One consideration is the conformation of Aβ targets. Targeting monomeric species has not resulted in robust clinical efficacy, whereas targeting Aβ in the form of oligomers, protofibrils, and plaques has shown evidence of slowing clinical decline. Another consideration is that mAbs will require safety monitoring for ARIAs.

Keywords: ARIA; Alzheimer disease; beta-amyloid; clinical trials; monoclonal antibody; neuroinflammation; protofibrils.

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Conflict of interest statement

Declaration of interest:

MN Sabbagh discloses ownership interest (stock or stock options) in NeuroTau, Inc., Optimal Cognitive Health Company, uMETHOD, Athira Pharma, Inc., Cognoptix, Inc., Cortexyme, Seq Biomarque, and EIP Pharma; consulting for Alzheon, Inc., Biogen Idec, GmbH, Genentech (Roche Group), Acadia Pharmaceuticals, Inc., T3D Therapeutics, Inc., Eisai Co., Ltd., Eli Lilly and Co., and KeifeRx. G Vitek and B Decourt declare no conflict of interest at the time this publication was written.

The authors have no other relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript apart from those disclosed.

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