Anvisa approves lecanemabe for early-stage Alzheimer's treatment

Brazil's National Health Surveillance Agency (Anvisa) approved the drug lecanemabe, marketed as Leqembi, on Thursday, January 8, for patients with early-stage Alzheimer's. The monoclonal antibody, administered via infusion, slows disease progression in individuals with mild cognitive impairment and confirmed beta-amyloid protein in the brain. The approval marks progress, though it is not a cure.

Brazil's National Health Surveillance Agency (Anvisa) announced the approval of lecanemabe, an innovative monoclonal antibody for treating early-stage Alzheimer's disease. Indicated for patients with mild dementia and cognitive impairment, the drug requires confirmation of beta-amyloid plaques in the brain, linked to the neurodegenerative condition.

The approval study involved 1,795 participants in the disease's early stage. Comparing the lecanemabe-treated group to a placebo, efficacy was assessed using the CDR-SB scale, which measures symptom severity and daily life impact after 18 months. Administration is via one-hour intravenous infusions every two weeks.

Similar to donanemabe (Kisunla), approved by Anvisa in April last year, lecanemabe does not cure the disease but slows its progression by targeting sticky structures that damage neurons. "The approval of this medication offers a new treatment option for people with early-stage Alzheimer's," says neurologist Paulo Caramelli, a professor at UFMG. He notes that it scientifically validates amyloid protein as a therapeutic target.

Restrictions limit use to initial stages, with no or one copy of the ApoE ε4 gene, and exclude advanced-stage patients or those with contraindications like anticoagulant use. Risks include ARIA, abnormalities such as brain swelling or bleeding, requiring strict screening and monitoring with MRI. Caramelli stresses the need for specialized teams: "Follow-up requires periodic complementary exams, mainly MRI."

Previously, treatments only managed symptoms; now, options like this slow cognitive and functional decline, preserving independence longer.

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Researcher analyzing brain MRI scans related to Alzheimer's drug lecanemab study, showing amyloid clearance but no glymphatic improvement.
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Study finds lecanemab clears amyloid but shows no short-term recovery in brain waste-clearance system

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Researchers at Osaka Metropolitan University report that while the Alzheimer’s drug lecanemab reduces amyloid plaques, MRI measures found no improvement in the brain’s glymphatic waste-clearance three months after treatment began, underscoring the disease’s complexity and the need for multi-target approaches.

Alzheimer's trials are shifting to a multi-target approach inspired by cancer research, even after failures with Novo Nordisk's semaglutide. Only two drugs, Eli Lilly's Kisunla and Eisai and Biogen's Leqembi, are widely approved to slow progression. This evolution treats the brain-wasting disease as a complex system, seeking new ways to halt it amid its global impact.

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Researchers at Brazil’s Federal University of ABC report a simple copper-chelating molecule that reduced beta-amyloid–linked pathology and improved memory in rats. The compound showed no detectable toxicity in preclinical tests and, based on computer modeling, is predicted to cross the blood–brain barrier. The team is seeking industry partners for clinical development.

Researchers at Kindai University report that oral arginine, a common amino acid, suppresses amyloid‑β aggregation and its toxic effects in fruit fly and mouse models of Alzheimer’s disease. In treated animals, amyloid buildup fell, inflammation markers dropped, and behavioral performance improved, suggesting arginine could be a low‑cost candidate for drug repurposing.

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Researchers have demonstrated that restoring levels of a key brain energy molecule can reverse advanced Alzheimer's disease in mouse models, repairing damage and restoring cognitive function. The study, published on December 22, challenges the long-held view that the condition is irreversible. Findings from human brain tissue support the approach's potential relevance to patients.

The US Food and Drug Administration (FDA) has approved mitapivat (brand name Aqvesme) for treating anaemia in adults with thalassaemia, working by improving red blood cell energy. The twice-daily pill can be taken by patients who need regular blood transfusions or those who do not. Experts say it could transform disease management in high-burden countries like India.

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A large study of nearly 2 million older adults has found that cerebral amyloid angiopathy, a condition where amyloid proteins build up in brain blood vessels, sharply increases the risk of dementia. Within five years of diagnosis, people with this disorder were four times more likely to develop dementia than those without it, even absent a history of stroke. The findings, drawn from Medicare records, underscore the need for early cognitive screening in affected individuals.

 

 

 

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