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Lecanemab: Full phase 3 trial results for the Alzheimer’s disease drug not as positive as HCPs expected

31.01.2023 | Insight

Lecanemab: Full phase 3 trial results for the Alzheimer’s disease drug not as positive as HCPs expected

Earlier this year, CREATION.co published an article on the approval of Aduhelm (aducanumab), a monoclonal antibody that targets amyloid beta found in the brains of people with Alzheimer’s disease, and which was also the first novel therapy approved for the disease since 2003. 

With the landscape of treatment now changing, particularly with the FDA accelerated approval of Eisais’ new Alzheimer’s disease drug, Leqembi (lecanemab-irmb), CREATION.co was prompted to follow up on what HCPs are saying in the online conversation about Alzheimer’s disease. CREATION.co analysed over 45K English language posts by nearly 12K distinct HCPs online from March 14th 2022 (following on from the end of the research period from our previous article) to December 11th 2022. 

Since CREATION.co’s previous Alzheimer’s disease article, the volume of online HCP conversation within the therapy area has remained consistent. Peaks in discussion surrounded an article that discussed the discovery of possible fabrication of images that could disprove the amyloid hypothesis, threatening the scientific progress in curing or slowing down Alzheimer’s disease. 

Phase 3 trial data for lecanemab has been a key driver of HCP conversations, with HCP sentiment shifting from positively celebrating initial trial data at the end of September 2022, to negative sentiments more recently. 

End of September: HCPs and news outlets celebrate Biogen and Eisai’s announcement of phase 3 trial results of lecanemab

Over half of HCP posts concerning the announcement of the phase 3 trial results of lecanemab were positive, with HCPs celebrating it as a ‘milestone’ and ‘huge news’. HCPs particularly celebrated that the drug met its primary endpoints.

When HCPs expressed a less positive sentiment, they primarily cautioned against excitement before a release of the full data and discussed the possible issue of toxicity.

Following release of the full trial data: HCP sentiments shift from largely positive towards increasingly negative

Compared to the largely positive sentiment following the initial announcement, HCP sentiment towards lecanemab became more  negative following the release of the full trial data, with under 10% of sentiment remaining positive. US neurologist Matthew Schrag called the data ‘not a breakthrough’, explaining in a thread that the actual benefits were ‘tiny’ and ‘will probably not be detectable’.

Expressing a similar sentiment, Eric Topol shared a blog on science.org, highlighting the statement that expressed doubt that lecanemab “will actually make a difference in the treatment of Alzheimer’s”.

Negative sentiments was also focused around the high risk of adverse effects observed during the trial, with Eric Topol highlighting his concern at the death of a patient on lecanemab, and neurologist Andreas Charidimou listing associated adverse events compared to the negligible clinical benefits:

Important to listen to HCPs, and not be drawn into hyperbolic reporting

Amidst the clinical conversation, British psychiatrist Professor Rob Howard highlighted the effect on patients of the hyperbolic reporting of the lecanemab trial data, a perspective often overlooked by clinicians and the media. Professor Howard shared the desperation of his own patients and his own experience of receiving calls in his clinic. He also shared his own official comment on the trial results in which he stated that he “…[suspects] that the lack of demonstrable clinical effectiveness will mean that lecanemab will not be taken up widely within healthcare systems around the World…” Importantly, he also shared a blog post by the adult child of a patient which stated, “…for anyone living with the condition now, it offers no immediate hope.

What I resent is the way this fact gets buried in the hyperbole, the false hope it generates, and the way it displaces efforts to do other – non-pharmaceutical – things that could be equally if not more immediately beneficial at improving people’s experience of living with dementia.”

Keeping the pulse on HCP conversation in Alzheimer’s disease

Despite lecanemab receiving accelerated FDA approval, HCP discussion online on the phase 3 trial results suggest that many HCPs believe that there is a long way to go before significant progress is made. HCPs celebration of the announcement of the initial trial results shifted towards concern and doubt as the full results were published, with clinical significance and benefits and adverse events leading HCPs to feel less than positive about lecanemab. As new developments occur in this therapy area, CREATION.co will continue to monitor HCP conversation to find out what they are saying.

 

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Francesca Gan

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