Opinion: Anti-amyloid drugs and the mystery of treatment-associated brain shrinkage

Eisai’s announcement that lecanemab, its antibody drug for Alzheimer’s disease that targets the buildup of amyloid protein in the brain, modestly slowed cognitive decline in a Phase 3 trial offers hope to people with Alzheimer’s disease. But what I’ll be looking for in the final data — which have not yet been presented or published — is whether the brain shrinkage seen in the Phase 2 trial remains.

As the investigators in that trial concluded, “The long-term implications of these findings are unknown and may be assessed in longer-term follow-up and in the phase 3 study (Clarity-AD).”

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