New infusion therapy offers hope for those with early-stage Alzheimer’s
By Sophos Geroulis, MD, ProHealth Care neurologist
Leqembi (Lecanemab) is an intravenous medication designed to slow the progression of early Alzheimer’s disease. Clinical studies have shown that Leqembi can help preserve memory and thinking abilities by reducing declines at an early stage, when independence and quality of life matter most.
Leqembi targets amyloid brain plaques – abnormal protein fragments (beta-amyloid) that build up between brain cells. In healthy brains, these proteins are cleared naturally. In Alzheimer’s disease they accumulate and form sticky plaques that disrupt communication between brain cells, trigger inflammation, lead to nerve cell damage and may even cause cells to die.
Over time, this damage makes it harder for the brain to process, store and retrieve information. High levels of amyloid plaques are strongly linked to symptoms such as memory loss, confusion and difficulty with problem-solving or reasoning.
Patients typically are referred to a neuroscience program by a primary care provider. The evaluation includes:
- Clinical history and neurological examination
- Neuropsychological testing
- Brain imaging (MRI or PET scans)
- Lumbar puncture for cerebrospinal fluid biomarkers, in select cases
Cognitive impairment and the presence of amyloid plaques must be confirmed before treatment can begin. It is important to note that no medication can currently restore lost memories or reverse established cognitive decline.
Eligible patients receive a Leqembi intravenous infusion every two weeks for 18 months. After this initial phase, therapy is intended to continue long-term on a maintenance schedule. The schedule generally moves to an intravenous infusion every four weeks or a weekly injection administered at home by the patient or a caregiver. Ongoing treatment is recommended, as clinical and biomarker data indicate that discontinuing therapy results in the return of the proteins and plaques and a loss of therapeutic benefit.
Patients are monitored by neurology, nursing and infusion staff. Regular neurological exams, cognitive testing and additional brain imaging tests ensure treatment effectiveness and safety. Monitoring includes screening for amyloid-related imaging abnormalities (ARIA), a possible treatment-related side effect.
Most insurers, including Medicare, now cover Leqembi for patients who meet clinical and biomarker criteria. Coverage typically includes the medication, infusion visits and necessary safety imaging, though prior authorization is required.
In addition to Leqembi, patients often benefit from supportive services including cognitive rehabilitation, occupational and speech therapy, and social work and counseling support. When used alongside infusion therapy, supportive services help maintain function, independence and quality of life.
Sophos Geroulis, MD, is a neurologist. He is part of the ProHealth Neuroscience Care team and sees patients in Waukesha and Sussex. Leqembi infusions are administered in the outpatient department at ProHealth Waukesha Memorial Hospital. Learn more at ProHealthCare.org/Neuroscience.
