Canada recently approved lecanemab for the treatment of early-stage Alzheimer’s disease, but the clinical benefit is modest, there is a risk of serious side effects, and the treatment is complex. article CMJ (Canadian Medical Association Journal) https://www.cmaj.ca/lookup/doi/10.1503/cmaj.260193 Provides an overview of medications and advises healthcare professionals to share decisions with patients and caregivers so they understand potential risks and benefits.
”Interpretation of the benefits of lecanemab may be influenced by the limited availability of treatments for Alzheimer’s disease and the personal and societal burden of Alzheimer’s disease. Clinical benefits are modest at best, and effects on quality of life, independence, and caregiver burden are uncertain.” wrote Dr. Sharon Strauss, a geriatrician at Unity Health Toronto and a professor at the University of Toronto in Toronto, Ontario, along with co-authors.
Although lecanemab is approved in Canada, it is expensive at about $35,000 to $40,000 per patient per year and is not publicly funded. In most states and territories, it remains unclear whether health insurance will cover it.
Lecanemab treatment is resource-intensive and requires specialized diagnosis, regular intravenous administration, and frequent monitoring with MRI scans. Patients with early-stage Alzheimer’s disease and confirmed amyloid in their brains are eligible if confirmed by PET scan or lumbar puncture with cerebrospinal fluid analysis. Swelling of the brain and small amounts of bleeding in the brain may occur as the drug attempts to remove amyloid, a protein that can build up in the brain in Alzheimer’s disease.
The authors encourage shared decision-making and provide tools to help clinicians engage with patients and caregivers.
”Given the uncertain clinical benefit, risk of adverse events, and resource and financial implications, the decision to start lecanemab should be made on an individualized basis. Some patients who value the possibility of slightly slowing disease progression may choose to proceed, accepting the risks, monitoring requirements, and out-of-pocket costs. In some cases, deferring treatment until further evidence is found may be a reasonable approach” concludes the author.
sauce:
Canadian Medical Association Journal
Reference magazines:
Weiss, S.M.; Others. (2026). Use of lecanemab for early Alzheimer’s disease in Canada. Journal of the Canadian Medical Association. DOI: 10.1503/cmaj.260193. https://www.cmaj.ca/content/198/25/E973
