We’ve talked at length on prior podcasts about the failures of aducnumab, Biogen, and the FDA’s decision to approve it.

But wait, there’s a shiny new anti-amyloid drug, lecanemab! (No it’s not just the French version of Aducanumab).

In an article in the NEJM (a published article this time, wonder of wonders!) lecanemab was shown to slow the rate of cognitive decline by 0.45 points on an 18 point cognitive scale compared to placebo. Wow! Wow? Wait, what?

On today’s podcast we talk with Jason Karlawish, who we’ve had on previously talking about his book The Problem of Alzheimer’s and with Aaron Kesselhim, to discuss FDA approval of Aducanumab, as well as frequent guest and host Ken Covinsky.

They debate today’s central question: is it time for geriatricians to get on board with lecanemab? Along the way we address:

Their answers may surprise you.

As a preview of final thoughts at the end of the episode, Ken and Jason agree that the FDA should approve lecanemab conditional on a post-approval monitoring system and public access to study data, geriatricians should be prepared to have thoughtful conversations with patients about the risks and benefits of lecanemab in view of their values and priorities, and ultimately, that geriatricians should be open to prescribing it.

Wow!

The times, they are a changin.

-@AlexSmithMD

Is it time for geriatricians to get on board with lecanemab? Jason Karlawish and Ken Covinsky

GeriPal - A Geriatrics and Palliative Medicine Podcast