Overview:
Lecanemab-irmb is an important drug that is used in the treatment of Alzheimer’s disease. It is available in the form of intravenous injections, which are administered to prevent the disease progression and to minimize the drug symptoms from exaggerating. The drug was approved by the Food and Drug Administration (FDA) on January 6th, 2023, due to its efficacy in improving the symptoms occurring in Alzheimer’s disease.
How Does Lecanemab-irmb Work?
In patients suffering from Alzheimer’s, the extracellular amyloid plaques are the characteristic feature of this condition. The drug acts on these accumulated brain plaques, which have distinct characteristics. They affect the disease state by causing synaptic impairment, neuronal death, and progressive neurodegeneration. The peptides could be in various forms, like soluble monomers, and increase the size of insoluble fibrils.
Uses:
The drug is specifically used for the treatment of Alzheimer’s disease, as it helps in improving mild cognitive impairment or dementia. It decreases certain substances known as amyloid beta, which usually builds up in the brain. This drug is not a cure for Alzheimer’s disease, but it may help delay the disability and worsening of the condition.
Dosage:
There are various dosage forms available for drug administration. The drug is only available in the form of intravenous injections and cannot be consumed in the form of oral capsules or tablets. Some of the available strengths of the drug are mentioned below:
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200 milligram/2 milliliter single-dose vial.
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500 mg/2 ml single-dose vial.
It is important to note that the drug should be diluted before administration. In addition, confirming the presence of amyloid beta pathology is important. Also, the treatment should be initiated in patients with mild cognitive impairment or early-stage dementia. There has never been any research done on a treatment's safety or efficacy in either the early or late stages of the disease.
Warnings:
While administering the drug, there are chances an individual may experience symptoms of infusion reactions. Some of them are mentioned below:
For Patients
What Is Alzheimer’s Disease?
It is a progressive, irreversible condition that affects the nervous system. It causes primary defects in the brain, which leads to memory loss and cognitive decline. The hallmark of the disease is the presence of abnormal proteins in the brain that disrupts the normal functioning of brain cells and result in gradual deterioration and loss of communication between neurons. About 6.5 million people over 65 years of age are affected by this condition. The early signs of the condition include forgetting recent events or conversations. Over time memory problems can affect the day-to-day activities of an individual. Some of the common symptoms associated with this condition are:
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Social withdrawal.
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Mood swings.
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Distrust in others.
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Altered sleeping habits.
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Anger.
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Wandering.
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Loss of inhibitions.
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Loss of interest in activities.
Although there are major changes in memory and skills, some individuals are still capable of holding on to certain skills even as symptoms worsen. These skills continue as it is associated with the brain that is affected in the later stages of the disease. The cause of the disease is due to the role of two proteins, which are mentioned below:
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Plaques - When beta-amyloid, which are fragments of a larger protein, clump together and exhibit toxic effects on the neurons and disrupt the communication between cells.
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Tangles - Certain proteins in the brain cell form a part of the internal support and transport system to transfer nutrients and other essential materials. The tangles are responsible for disrupting the transport system and causing damage to cells. For example, the au proteins undergo changes in shape to organize themselves into structures which are called neurofibrillary tangles.
Learn More About Lecanemab-irmb:-
When and How Often to Take Lecanemab-irmb?
The drug is administered intravenously once in two weeks for a better course of action and efficacy. It is usually administered in the hospital under the supervision of a healthcare professional. Frequent patient monitoring is required to ensure the patient's safety and prevent adverse reactions.
How Effective Is Lecanemab-irmb?
The drug has exhibited a statistically significant reduction in brain amyloid levels. It slows down the disease progression and has proven better efficacy in treating the condition.
Things to Inform the Doctor Before They Prescribe Lecanemab-irmb:
Before the doctor prescribes the drug, it is best to inform of any previous history of allergies. In addition, informing about the medical and drug history can help the doctor administer the drug or consider altering the dose to prevent any unwanted drug interactions.
Starting Lecanemab-irmb:-
How to Take Lecanemab-irmb?
The drug is usually administered as an intravenous infusion. The recommended dosage is about 10 mg/kg once every two weeks. If the drug is administered once every two weeks, the infusion lasts about one hour.
Things to Do After Starting Taking Lecanemab-irmb:
It is important to follow up on the appointment with the doctor to avoid missing any dosage. Delaying the treatment can have an impact on the progression of the disease and delay the recovery of the patient.
Look Out for Side Effects:
The drug may cause swelling of the brain and could have small bleeding spots on the brain surface. So the doctor may perform magnetic resonance imaging before and after treatment to watch out for side effects. Some additional side effects of the drug are mentioned below:
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Difficulty in breathing.
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Swelling in the face.
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Headache.
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Confusion.
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Dizziness.
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Nausea.
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Difficult walking.
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Seizures.
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Allergic reactions.
Dietary Alterations:
No specific diet alterations are required while consuming the drug. Intake of a balanced and healthy diet can aid in quality living. Unless specifically mentioned by the dietician or the healthcare professional, a regular diet will suffice.
What Should Be Done When a Dose Is Missed?
In case of missing a dose, it is important to report at the earliest possible. Skipping doses frequently could delay the prognosis of the disease.
What Should Be Done to Treat Lecanemab-irmb Overdose?
In case of an overdose, seeking immediate medical help and informing the healthcare providers about the medication being ingested is important. In addition, it is important to monitor vital signs like blood pressure and heart rate. Activated charcoal or gastric lavage may be administered to remove the medication from the body.
How to Store Lecanemab-irmb?
The drug is stored at room temperature for better safety and efficacy. Do not freeze or store in cold temperatures. Keep the drug away from children and pets to avoid accidental ingestion of the drug. Also, carefully discard the needles safely to prevent anyone from accidentally injuring themselves.
How to Handle Lecanemab-irmb?
The drug has to be handled carefully in a safe environment. It is important to use a sterile needle to ensure no contamination or cross-infection. It is important to wipe the site of injection with alcohol and administer the drug intravenously for a duration of one hour for slow and proper administration of the drug.
How to Dispose of Lecanemab-irmb?
When disposing of the drug, it is better to follow the precautions given by the manufacturer. Many local take-back programs allow the return of unused or expired drugs safely. Do not discard the drug along with regular waste, as it could result in environmental hazards. Before disposing of any drug, it is important to remove personal information to prevent any drug misuse.
Avoid Self-Medication:
Self-medication can cause unwanted adverse effects. So it is always better to take medications under the supervision of healthcare professionals.
Staying On Lecanemab-irmb:-
It is important to take the drug at the same time every day. So it is important to keep reminders to take the medication promptly for better recovery.
For Doctors:-
Indication:
The drug is used in patients suffering from Alzheimer’s disease. The drug does not completely cure the condition but helps improve the disease's symptoms and prevents further progression. So it is preferably used in mild or moderate dementia for better results.
Pharmacology:
Mechanism of Action:
The drug is a monoclonal antibody that is directed towards soluble and insoluble forms of amyloid protein. The drug targets the soluble oligomers and insoluble fibrils. As the drug is a humanized immunoglobulin gamma 1, it helps to get rid of the amyloid beta plaques in the brain, which defines the pathophysiological feature of Alzheimer’s disease.
Ingredients:
Active Ingredient: Lecanemab-irmb.
Inactive Ingredients:
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Methylcellulose.
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Sterile water.
Absorption:
The drug is absorbed rapidly into the bloodstream as it is administered intravenously. The absorption is quick and rapid. The steady-state concentration of the drug is reached in approximately six weeks when the drug is administered every two weeks. Systemic accumulation of the drug was observed to be one to four folds. The plasma concentration of the drug increases the dose proportionally after a single dose.
Distribution:
The mean volume of drug distribution is about 0.85 US gallons. It is degraded by proteolytic enzymes.
Metabolism and Elimination:
The drug is degraded by proteolytic enzymes, which help to undergo complete metabolism. The half-life of the drug is about five to seven days. The drug is not expected to undergo any elimination via the kidneys or hepatic enzymes. If there is any incidence of anti-drug antibodies, it is highly dependent on the sensitivity and specificity of the assay.
Toxicity:
The drug can cause severe risks like brain swelling and bleeding. In addition, it could also lead to hypersensitivity reactions like angioedema, bronchospasm, and anaphylaxis. In such cases, the drug should be discontinued if there are any such reactions, and appropriate therapy should be initiated.
Administration of the Drug:
The drug is administered via the intravenous route once every two weeks. Each intravenous injection lasts for approximately one hour for every infusion. This drug administration is usually performed in hospitals under the supervision of healthcare professionals.
Contraindications:
The drug is contraindicated for use in pediatric patients and breastfeeding mothers, as there are no clear results establishing the drug's safety in such patients.
Clinical Studies for Lecanemab-irmb:
Many studies have included the safety and efficacy of the drug. A study conducted on 1,795 people with early Alzheimer’s disease who were aged about 50 to 90 years received a dosage of 10 mg/kg every two weeks. The patients showed drastic prognoses in disease progression and, thereby, were able to exhibit lesser symptoms.
Drug Interactions:
The drug interactions could increase the risk of side effects. The drug does not specifically interact with other drugs, so there are not many potential risks that have been reported.
Other Specifications:-
Lecanemab-irmb in Pregnant Women:
Various clinical studies are being conducted to understand the drug's efficacy in pregnant women. However, it is better to consider the risks before administering the drug.
Lecanemab-irmb in Lactating Women:
The use of the drug in lactating women is not clearly understood. The drug must be carefully administered as it may cause defects in children.
Lecanemab-irmb in Pediatric Patients:
The drug is not indicated for use in pediatric patients. It is safer to avoid usage as it could cause unwanted complications. Some complications, like alterations in cognitive behavior and birth defects, are most likely to occur. Also, it is rare to affect young children, as Alzheimer’s disease is highly associated with elderly individuals.
Lecanemab-irmb in Geriatric Patients:
The drug is used in geriatric patients who suffer from Alzheimer’s disease. But before administering the drug, it is important to look for comorbidities. Also, in some patients, dosage alteration may be required.
Lecanemab-irmb in Renal Impairment Patients:
The usage of the drug in renal-impaired patients is under study. So it is safer to avoid the drug in renal-impaired patients. The medical professional will decide the need for drug usage based on the severity of the disease and alter the dosage as per the requirements.
Lecanemab-irmb in Hepatic Impairment Patients:
The exact use of the drug in hepatic-impaired patients is not clearly understood. Hence it is safer to closely monitor the patient during drug administration to ensure proper recovery and to avoid side effects. In certain patients, dosage alterations are recommended for better drug tolerance.
