Is it time for geriatricians to get on board with lecanemab? Jason Karlawish and Ken Covinsky
episode
GeriPal - A Geriatrics and Palliative Medicine Podcast
49 min
4 speakers
7 chapters
transcribed 11 hours ago
Transcript
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What is the main topic discussed in this episode?
The JerryPoL Podcast is supported by listeners like you, who've either spread the word on social media, left reviews on podcasting apps, or have clicked on our donate button on the JerryPAL website so we can continue to fund each one of these episodes. Welcome to the Jerry Pal podcast. This is Eric Wadera.
This is Alex Smith.
And Alex, I'm gonna love this one. Who do we have with us today?
This one won't be controversial at all. We're delighted to welcome back Jason Carlowish, who's professor of medicine and co director of the Penn Memory Center at the University of Pennsylvania, Pearlman School of Medicine. Welcome back to the JerryPell podcast, Jason.
Great to be back. Alex and Eric.
And we're delighted to welcome back Ken Kavinski, who's Professor of Medicine and Geriatrics at UCSF. Welcome back, Ken. It's an honor and a privilege to be back.
Uh so today's podcast. So we've had Jason on before, uh talking about both dementia, his book, which we'll have links to in the show notes, and also about adjucanimab. But this podcast is not on adjucanimab, it's on licanimab, which was just published in the New England Journal, anti-amyloid drug for dementia, Alzheimer's disease. Before we go into that topic, which we got a lot of ground to cover. Jason, I think you got a song request for Alex.
Alex The times there are changing.
Yeah. Great choice. Pay close then to the second verse lyrics. I think they're appropriate.
Come gather around people wherever you roam, and admit that the waters around you have grown, and accept it that soon you'll be drenched to the bone. If your time to you is worth saving. Then you better start swimming or you'll sink like a stone for the times they are a changing. Come writers and critics who prophesize with your pen and keep your eyes wide open the chance won't come again And don't speak too soon for the wheel's still in spin There's no telling who that it's name and For the looter now will be later to win.
What is lecanemab and how does it differ from aducanumab?
For the times they are a change.
Bravo. Very apropos.
Brilliant. The other title I wanted uh but you apparently was already co opted by uh Sean Morrison was uh We Won't Get Fooled Again by the Who.
Uh huh. That is awesome. Isn't it cool that like Bob Dylan won a Nobel Prize for Literature for lyrics? Very cool. Incredible songwriter. Yeah. Poet,
yeah.
So a couple of weeks ago, we did a podcast on the need for cultural transformation around dementia care. We didn't bring up actually we we touched upon Lacanimab and anti-amyloid antibodies, but really thinking about other other ways we can transform dementia care. This podcast ultimately we want to get to the question should the field of geriatrics Get on board. with lcanomab and these anti amyloid drugs. Um because There's been a lot of pushback from geriatricians, including our organ national organization, American Geriatrical Society, pushing back against at least adjucanamam. The question is, should we have that same take on this new drug? So let's start off from the beginning. Jason What the heck is Lacanimab?
Am I pronouncing that right? I probably should know how to pronounce it. It's
a French version, right? Of Aducanimab? Yeah, exactly. Maybe. No, it's a different.
Yeah, no, Adecanimab remains the dumpster fire. Lacanimab is the well, let's just say this it's study maybe says it all Clarity. It was the name of their clinical trial, the Clarity study. Lacanimab is an anti-amyloid antibody. Uh it's delivered by intervenous infusion uh every two weeks. It targets soluble amyloid species in the amyloid cascade. And it was studied in Clarity AD, a uh phase three, 18-month-long uh single dose 50-50 drug versus placebo clinical trial, enrolling people with mild cognitive impairment, mild stage dementia who had elevated amyloid by PET scan. That's the guts of the study and that's the drug.
So it it seems to really again another drug focused on the amyloid hypothesis. Do we know if it does anything to any other of these uh biomarkers like tau?
Yeah, so it is an anti amyloid drug and one key message with anti amyloid drugs is they're not all the same.
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Chapters
7 chapters
1
What is the main topic discussed in this episode?
0:01–2:26
2
What is lecanemab and how does it differ from aducanumab?
2:26–11:13
3
What were the design, participants, and primary endpoints of the Clarity AD trial?
11:13–21:53
4
How significant was the 0.45‑point slowing of cognitive decline on the CDR‑SB scale?
21:53–28:37
5
What secondary outcomes (tau, caregiver burden, quality‑of‑life) did lecanemab improve?
28:37–35:48
6
What are the major safety concerns (ARIA, microbleeds, APOE‑4 risk) and how are they monitored?
35:48–48:25
7
How well did the trial address inclusion, diversity, and real‑world accessibility?
48:25–50:01
Speakers
4 identifiedMore from GeriPal - A Geriatrics and Palliative Medicine Podcast
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Who Should Palliative Care See? Diane Meier, Bob Arnold, and Justin Sanders
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