Li Jiahao, Zhang Feng, Eisel Ulrich Lm
Department of Molecular Neurobiology, Groningen Institute of Evolutionary Life Science (GELIFES), University of Groningen, Groningen, The Netherlands.
Department of Neurology, The Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, China.
J Alzheimers Dis. 2025 Jun;105(3):849-859. doi: 10.1177/13872877251333084. Epub 2025 Apr 23.
BackgroundLecanemab, a monoclonal antibody targeting amyloid-β plaques, is FDA-approved for early Alzheimer's disease (AD) treatment. However, safety data from daily clinical practice is limited.ObjectiveThis study aims to assess the adverse events (AEs) linked to lecanemab using the FDA Adverse Event Reporting System (FAERS) to inform better safety management.MethodsA retrospective pharmacovigilance study was conducted using FAERS data from Q1 2023 to Q2 2024. Disproportionality analysis, including reporting odds ratio (ROR), proportional reporting ratio (PRR), Bayesian confidence propagation neural network (BCPNN), and multi-item gamma Poisson shrinker (MGPS), was applied to evaluate AEs where lecanemab was the primary suspect drug.ResultsFrom Q1 2023 to Q2 2024, 917 AEs related to lecanemab were recorded in the FAERS database, with 67.2% of patients aged between 65 and 85 years and 54.5% involving women. Disproportionality analysis identified significant AEs across 22 organ systems, particularly nervous system and psychiatric disorders. Common AEs included headache, amyloid-related imaging abnormalities, and infusion-related reactions, while sleep-related issues like somnolence, abnormal dreams, and poor-quality sleep were notable. Median onset time was 48 days, with serious outcomes in 14.3% of cases, including 70 hospitalizations and 15 deaths.ConclusionsThis pharmacovigilance analysis confirms known AEs of lecanemab and highlights new safety concerns, particularly its impact on sleep. These findings underscore the importance of ongoing monitoring and research to enhance lecanemab's safety profile in AD treatment. However, due to the limitations of FAERS, our analysis is imperfect in terms of important AEs such as therapy-related brain loss and death.
背景
莱卡奈单抗是一种靶向淀粉样β斑块的单克隆抗体,已获美国食品药品监督管理局(FDA)批准用于早期阿尔茨海默病(AD)的治疗。然而,来自日常临床实践的安全数据有限。
目的
本研究旨在使用FDA不良事件报告系统(FAERS)评估与莱卡奈单抗相关的不良事件(AE),以更好地进行安全管理。
方法
利用2023年第一季度至2024年第二季度的FAERS数据进行回顾性药物警戒研究。采用不成比例分析,包括报告比值比(ROR)、比例报告比值(PRR)、贝叶斯置信传播神经网络(BCPNN)和多项目伽马泊松收缩器(MGPS),评估以莱卡奈单抗为主要可疑药物的不良事件。
结果
2023年第一季度至2024年第二季度,FAERS数据库中记录了917例与莱卡奈单抗相关的不良事件,67.2%的患者年龄在65至85岁之间,54.5%涉及女性。不成比例分析确定了22个器官系统中的重大不良事件,特别是神经系统和精神疾病。常见的不良事件包括头痛、淀粉样蛋白相关影像异常和输液相关反应,而与睡眠相关的问题如嗜睡、异常梦境和睡眠质量差也较为显著。中位发病时间为48天,14.3%的病例出现严重后果,包括70例住院和15例死亡。
结论
这项药物警戒分析证实了莱卡奈单抗已知的不良事件,并突出了新的安全问题,特别是其对睡眠的影响。这些发现强调了持续监测和研究以改善莱卡奈单抗在AD治疗中的安全性的重要性。然而,由于FAERS的局限性,我们的分析在诸如治疗相关脑萎缩和死亡等重要不良事件方面并不完善。