Duke Study Shows Alzheimer's Drug Safe for 80% of Patients

When Sally Osmer received her Alzheimer's diagnosis at 74, she didn't let fear stop her from trying a new treatment that could slow her decline.

Duke Health researchers studied 230 patients like Osmer who received lecanemab, an FDA-approved therapy that removes harmful proteins from the brain. The results, published in Neurology Open Access, offer reassuring news for families facing one of medicine's toughest diagnoses.

The study found that 80% of patients continued treatment for at least a year. Most who stopped did so because of side effects, but the majority of these side effects resolved without hospitalization or additional medications.

The most watched concern was brain swelling or bleeding, known as ARIA. About one in four patients developed this condition, but researchers found patterns that can help doctors monitor patients more carefully. ARIA events peaked around 10 weeks and 25 weeks after starting treatment, showing when extra vigilance matters most.

"There's been a lot of fear about this medication," said Dr. Andrew Liu, the study's lead author and professor at Duke University School of Medicine. "What we found is that with careful selection and close monitoring, most patients are able to stay on treatment safely."

Duke Health has now treated more than 400 patients with lecanemab, making it one of the most experienced centers in the country. The team is using artificial intelligence to detect subtle brain changes earlier, strengthening patient safety.

The Bright Side

Researchers discovered that patients with a high-risk Alzheimer's gene were four times more likely to develop side effects. This knowledge helps doctors identify who needs closer monitoring and gives families better information for making treatment decisions.

The study also found that cognitive performance remained stable at 12 months, whether patients developed ARIA or not. This suggests the therapy continues working even when side effects occur.

For Osmer, who has a family history of Alzheimer's, starting treatment brought relief. "The prospect of having a slow decline but being physically healthy is very frightening," she said. "We were fortunate to catch it early, and I was pleased to begin treatment."

Duke researchers are now building a biorepository with samples from treated patients to develop better tests for predicting who will develop side effects. The goal is to make treatment safer and more personalized for everyone.

These real-world results match what clinical trials showed, proving the therapy works outside controlled research settings and bringing genuine hope to the 6 million Americans living with Alzheimer's.

##