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Expert Interview

Slingshot members are talking to an expert! The topic is:

Discussing Biogen/Eisai’s Lecanemab Phase 3 Clarity AD results in early Alzheimer's disease

Ticker(s): BIIB

Who's the expert?

Institution: University of Miami 

  • Assistant Professor of Clinical Neurology in the Movement Disorders Division at the University of Miami.
  • Currently manages 80 patients with Alzheimer's disease.
  • Research interests include Parkinson' disease and a broad interest in neurodegenerative disorders and movement disorders in particular.

Interview Questions
Q1.

Please describe your clinical practice,how many patients with Alzheimer's do you treat on a yearly basis? Tell us in short about the standard of care, and the most promising upcoming treatments.

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Q2.

Lecanemab is said to have reduced clinical decline on the global cognitive and functional scale, CDR-SB, compared with placebo at 18 months by 27%. Can you please give us your high-level thoughts on this important primary endpoint?

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Q3.

The total incidence of ARIA (ARIA-E and/or ARIA-H) was 21.3% in the lecanemab group and 9.3% in the placebo group. How does this compare to competition?

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Q4.

Dr. Lon Schneider is quoted in the press as saying the relatively low rates of brain swelling and bleeding suggest that lecanemab is easier to use than Aduhelm, and that, however, the effect “is small and would not be considered by many as a minimally clinically important difference.” Could you please share with us your insights?

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Q5.

Judging from the results, how likely/unlikely is it to be overturned in sensitivity analyses that look for confounding effects?

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Q6.

Researchers also noted the absolute difference in CDR-SB scores was small, at 0.45, with some questioning how clinically meaningful this is. What’s your take on that?

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Q7.

From the full dataset, what results would be most important to keep an eye on in the future: subgroup effects, (for APOE4 carriers)/ potential unblinding due to ARIA/ safety data/ biomarker findings (for tau)?

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