Novel anti-amyloid-beta (Aß) monoclonal antibody lecanemab for Alzheimer's disease: A systematic review.

BACKGROUND: Lecanemab is the latest monoclonal antibody that targets beta-amyloid approved exclusively for treatment of Alzheimer's disease with mild cognitive impairment or mild dementia. This article aims to provide a systematic review of the efficacy, and safety of lecanemab in slowing clinical decline in Alzheimer's disease. METHODS: A comprehensive search of various databases, including the National Institute of Health clinical trials registry, PubMed, and the Cochrane library, was conducted until July 2023 using the keywords lecanemab, BAN2401, and Alzheimer's disease. Additionally, conference abstracts listed in the Cochrane database (including Embase) and drug information from the US Food and Drug Administration (FDA) label were examined. Only clinical trials published in the English language were considered. In total, 107 articles were retrieved, and after thorough evaluation, three randomized, double-blind, multicenter clinical trials involving 2729 participants were included in the analysis. RESULTS: The FDA approved lecanemab for Alzheimer's disease in January 2023 which acts as a novel disease-modifying anti-amyloid-beta (Aß) human monoclonal antibody and is administered intravenously. Based on the clinical trials included in this review, lecanemab was found efficacious in reducing the accumulation of beta-amyloid and slowing down the cognitive decline and it was well tolerated. Lecanemab had a statistically significant change from baseline in Clinical Dementia Rating-Sum of Boxes (CDR-SB), Alzheimer's Disease Composite Score (ADCOMS), Alzheimer's Disease Assessment Scale (ADAScog14), Alzheimer's Disease Cooperative Study-Activities of Daily Living Scale for Mild Cognitive Impairment (ADCS-MCI-ADL), and reductions in brain amyloid burden. The most common treatment-emergent adverse events were headache, infusion-related reactions, and Amyloid related imaging abnormalities-edema. CONCLUSIONS: Lecanemab therapy led to a substantial decrease in amyloid plaques and a noticeable slowing of clinical decline. The findings suggest a meaningful connection between the reduction in amyloid and the positive impact on patients' clinical outcomes, hinting at potential disease-modifying effects.

Omicron variant of SARS-CoV-2 infection elicits cross-protective immunity in people who received boosters or infected with variant strains.

INTRODUCTION: The B.1.1.529 (Omicron) variant of SARS-CoV-2 is the most antigenically unique SARS-CoV-2 variant of concern to date, which is currently widespread across the world. Omicron variant and its sublineages contain a plethora of mutations than other variants of concern, which increases their transmissibility and virulence. Concerns regarding potential immunological evasion have been reignited by emerging subvariants of the Omicron variant. Determining the effectiveness of Omicron-induced immunity and whether it is cross-protective against other variants is a crucial aspect of the research. METHOD: A systematic search of relevant articles until September 25, 2022, from databases such as PubMed, Scopus, Google Scholar, and ScienceDirect was done independently by two authors. A total of 11 articles discussing about immunological evasion of different Omicron subvariants were included in the study. RESULTS: Numerous studies have demonstrated that Omicron variant causes a restricted immune response after infection. Omicron infection boosts preexisting vaccine-induced immunity, but it may not be enough to establish widespread, cross-neutralizing humoral immunity in unvaccinated people. CONCLUSION: Due to co-circulation and the emergence of novel SARS-CoV-2 variants, findings highlight the importance of booster vaccinations for immune protection. More studies should focus on the efficacy of Omicron-induced immunity, its cross-protective properties against other variants, and development of a universal vaccine.