However, many of these people also had a history of cancer, heart problems, diabetes or obesity — conditions that excluded patients from participating in the Leqembi and Aduhelm clinical trials.
Espay said the results “give us an idea” of the proportion of patients in the real world likely to get treatment. But, he added, given that Alzheimer’s is such a devastating disease, it’s unlikely that all physicians will only rely on trial data when deciding whether to prescribe these drugs to their patients.
Dr. Stephen Salloway, a professor of neurology at the Alpert Medical School of Brown University, said the results underscore the importance of careful patient selection in trials to help identify patients most likely to benefit from treatment. Those risks include side effects from Leqembi and Aduhelm such as headache, confusion, dizziness, vision problems and nausea. They also carry serious risks of brain swelling and brain bleeds, which led the FDA to give Leqembi its strongest safety warning label when the drug was approved, saying that these side effects could lead to seizures and death.