This study aimed to determine the efficacy of amyloid clearance of lecanemab in patients with Parkinson's disease (PD) with amyloid co-pathology. Lecanemab, an anti-amyloid monoclonal antibody, was apporoved by the US FDA in July 2023 and in South Korea in May 2024, as a disease-modifying therapy based on its clinical efficacy and reduction of amyloid plaques in patients with early-stage Alzheimer's disease (AD). AD pathology is also common in PD, and approximately 35% of patients with PD dementia have co-existing AD pathology. Currently, no mediations have been developed to slow the progression of PD. Therefore, this study aimed to determine whether reducing the amyloid burden in patients with PD with co-exsistent AD pathology could potentially slow disease progression. To test it, patients with PD with mild cognitive impairment or early dementia, who were confirmed to have amyloid deposition through amyloid imaging, would be enrolled as a treatment arm, and the degree of reduction of amyloid plaque after 18 months of lecanemab administration would be investigated.
This study plans to consecutively enroll the patients with Parkinson's disease (PD) who have confirmed amyloid deposition on amyloid imaging and meet the indications for lecanemab administration. After a thorough explanation of lecanemab administration, patients who consent to the treatment would be enrolled. Patients assinged to the treatment arm would receive standard lecanemab treatment (10mg/kg intravenous infusion every two weeks for 18 months) and standard PD care. Patients who do not consent to the administration of lecanemab would receive stadnard care for PD and be monitored their progress without any further intervention.
Study Type
INTERVENTIONAL
Allocation
NON_RANDOMIZED
Purpose
TREATMENT
Masking
NONE
Enrollment
60
Patients assigned to this arm receive lecanemab 10mg/kg intravenously every two weeks for 18 months.
Patients assigned to this arm do not receive lecanemab 10mg/kg intravenously during the follow-up period
Yonsei University College of Medicine
Seoul, South Korea
Changes in amyloid dposition on amyloid imaging scans
Changes in amyloid dposition (i.e., global FBB SUVR) on amyloid imaging scans (18F-FBB PET) after lecanemab administration in the lecanemab adminstration group
Time frame: Change from baseline to 18 months
longitudinal changes in the MMSE score
The change in Mini-Mental State Examination (MMSE) score from baseline to 18 months will be compared between the lecanemab administration group and the non-administration group.
Time frame: Change from baseline to 18 months
longituidnal changes in UPDRS-III scores.
The change in Unified Parkinson's Disease Rating Scale Part III (UPDRS-III) score from baseline to 18 months will be compared between the lecanemab administration group and the non-administration group.
Time frame: Change from baseline to 18 months
Longitudinal changes in the plasma and cerebrospinal fluid biomarkers
Longitudinal changes in the plasma and cerebrospinal fluid biomarkers regarding the Alzheimer's disease in the lecanemab administration group.
Time frame: Change from baseline to 18 months
longitudinal changes in the MoCA score.
The change in Montreal Cognitive Assessment (MoCA) score from baseline to 18 months will be compared between the lecanemab administration group and the non-administration group.
Time frame: Change from baseline to 18 months
longitudinal changes in CDR-SB.
The change in Clinical Dementia Rating-Sum of Boxes (CDR-SB) score from baseline to 18 months will be compared between the lecanemab administration group and the non-administration group.
Time frame: Change from baseline to 18 months
longituidnal changes in composite scores of each cognitive domain.
The change in composite scores of cognitive domains from baseline to 18 months will be compared between the lecanemab administration group and the non-administration group.
Time frame: Change from baseline to 18 months
longituidnal changes in levodopa-equivalent doses per body weight [mg/kg].
The change in levodopa-equivalent dose (LED) from baseline to 18 months will be compared between the lecanemab administration group and the non-administration group.
Time frame: Change from baseline to 18 months
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