{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T04:51:04Z","timestamp":1787028664267,"version":"build-2736575974"},"reference-count":13,"publisher":"MDPI AG","issue":"23","license":[{"start":{"date-parts":[[2025,11,21]],"date-time":"2025-11-21T00:00:00Z","timestamp":1763683200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Technology Enhancing Cognition and Health\u2014Geriatric Research Education and Clinical Center (TECH-GRECC), VA Pittsburgh Healthcare System","award":["N\/A"],"award-info":[{"award-number":["N\/A"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Background\/Objectives: While lecanemab (Leqembi) and several amyloid targeting therapies were approved for Alzheimer\u2019s disease, questions remain on real-world implementation, safety, and effectiveness. The objective of this study was to describe the uptake and early outcomes of Veterans initiating lecanemab. Methods: This retrospective cohort study included Veterans who initiated lecanemab in the Veteran\u2019s Health Administration (VHA) between October 2023 and July 2024. Treatment persistence and monitoring, change in Montreal Cognitive Assessment (MoCA) score, incidence of adverse events, including amyloid-related imaging abnormalities (ARIA), and healthcare utilization were analyzed at 7 months. Results: Overall, 32 Veterans (mean [SD] age 75.3 [6.0] years, 100% male, 97% white, 84% urban dwelling) initiated lecanemab. Seventeen patients (53%) had mild cognitive impairment, 15 (47%) had mild dementia; mean baseline MoCA score was 21.3 (SD 3.4). At 7 months following treatment initiation, we assessed process, safety, and effectiveness outcomes. Process outcomes: In all, 25 patients (78%) were persistent with treatment. Safety outcomes: Three patients (9%) experienced a stroke, and 7 (22%) experienced ARIA. Effectiveness outcomes: Only 12 (38%) patients had a MoCA completed by 7 months, and the mean change in MoCA was 0.0 (SD 3.7, p = 1.0). A follow-up amyloid positron emission tomography (PET) scan was completed by 9 (28%) patients, and 5 had reductions in amyloid. Conclusions: Initial observations in a small VHA cohort suggest that uptake of lecanemab was limited, and the finding that nearly 30% of patients experienced ARIA or stroke within 7 months of initiation underscores the importance of monitoring the lecanemab safety and effectiveness long-term. These early findings should be interpreted cautiously given the limited sample size and very limited follow-up MoCA data.<\/jats:p>","DOI":"10.3390\/jcm14238277","type":"journal-article","created":{"date-parts":[[2025,11,21]],"date-time":"2025-11-21T12:41:58Z","timestamp":1763728918000},"page":"8277","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Early Outcomes of Lecanemab for Alzheimer\u2019s Disease in the Veterans Health Administration"],"prefix":"10.3390","volume":"14","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1326-676X","authenticated-orcid":false,"given":"Alison J.","family":"O\u2019Donnell","sequence":"first","affiliation":[{"name":"Technology Enhancing Cognition and Health-Geriatric Research, Education, and Clinical Center (TECH-GRECC), VA Pittsburgh Healthcare System, Pittsburgh, PA 15240, USA"},{"name":"Division of Geriatrics, Department of Medicine, University of Pittsburgh, Pittsburgh, PA 15213, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xinhua","family":"Zhao","sequence":"additional","affiliation":[{"name":"Center for Health Equity Research and Promotion (CHERP), VA Pittsburgh Healthcare System, Pittsburgh, PA 15240, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alyssa","family":"Parr","sequence":"additional","affiliation":[{"name":"Center for Health Equity Research and Promotion (CHERP), VA Pittsburgh Healthcare System, Pittsburgh, PA 15240, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sherrie","family":"Aspinall","sequence":"additional","affiliation":[{"name":"Center for Health Equity Research and Promotion (CHERP), VA Pittsburgh Healthcare System, Pittsburgh, PA 15240, USA"},{"name":"VA Center for Medication Safety, Washington, DC 20420, USA"},{"name":"Department of Pharmacy and Therapeutics, School of Pharmacy, University of Pittsburgh, Pittsburgh, PA 15261, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Timothy S.","family":"Anderson","sequence":"additional","affiliation":[{"name":"Technology Enhancing Cognition and Health-Geriatric Research, Education, and Clinical Center (TECH-GRECC), VA Pittsburgh Healthcare System, Pittsburgh, PA 15240, USA"},{"name":"Center for Health Equity Research and Promotion (CHERP), VA Pittsburgh Healthcare System, Pittsburgh, PA 15240, USA"},{"name":"Division of General Internal Medicine, Department of Medicine, University of Pittsburgh, Pittsburgh, PA 15213, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2025,11,21]]},"reference":[{"key":"ref_1","unstructured":"Alzheimer\u2019s Association (2025). 2025 Alzheimer\u2019s Disease Facts and Figures. Alzheimer\u2019s Dement., 21, e70235."},{"key":"ref_2","unstructured":"(2025, September 24). Statistical Projections of Alzheimer\u2019s Dementia for VA Patients, VA Enrollees, and U.S. Veterans Fiscal Years 2021 and 2033, Available online: https:\/\/www.va.gov\/GERIATRICS\/docs\/VHA_ALZHEIMERS_DEMENTIA_Statistical_Projections_FY21_and_FY33_sgc121820.pdf."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"451","DOI":"10.18865\/ed.29.3.451","article-title":"US Military Service and Racial\/Ethnic Differences in Cardiovascular Disease: An Analysis of the 2011\u20132016 Behavioral Risk Factor Surveillance System","volume":"29","author":"Walker","year":"2019","journal-title":"Ethn. Dis."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"608","DOI":"10.1001\/archgenpsychiatry.2010.61","article-title":"Posttraumatic Stress Disorder and Risk of Dementia Among US Veterans","volume":"67","author":"Yaffe","year":"2010","journal-title":"Arch. Gen. Psychiatry"},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"9","DOI":"10.1056\/NEJMoa2212948","article-title":"Lecanemab in Early Alzheimer\u2019s Disease","volume":"388","author":"Swanson","year":"2023","journal-title":"N. Engl. J. Med."},{"key":"ref_6","unstructured":"(2025, October 20). 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[3rd ed.].","DOI":"10.1002\/9780470669600"},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"512","DOI":"10.1001\/jama.2023.13239","article-title":"Donanemab in Early Symptomatic Alzheimer Disease: The TRAILBLAZER-ALZ 2 Randomized Clinical Trial","volume":"330","author":"Sims","year":"2023","journal-title":"JAMA."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"655","DOI":"10.1001\/jamaneurol.2025.1232","article-title":"Lecanemab Treatment in a Specialty Memory Clinic","volume":"82","author":"Paczynski","year":"2025","journal-title":"JAMA Neurol."},{"key":"ref_12","unstructured":"(2025, September 24). Two-Year Real-World Study of LEQEMBI\u00ae in the United States Presented at Alzheimer\u2019s Association International Conference (AAIC) 2025. Available online: https:\/\/media-us.eisai.com\/2025-07-30-Two-Year-Real-World-Study-of-LEQEMBI-R-in-the-United-States-Presented-at-Alzheimers-Association-International-Conference-AAIC-2025."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"9","DOI":"10.14283\/jpad.2022.102","article-title":"Establishing Clinically Meaningful Change on Outcome Assessments Frequently Used in Trials of Mild Cognitive Impairment Due to Alzheimer\u2019s Disease","volume":"10","author":"Lansdall","year":"2023","journal-title":"J. Prev. Alzheimer\u2019s Dis."}],"container-title":["Journal of Clinical Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2077-0383\/14\/23\/8277\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,11,21]],"date-time":"2025-11-21T12:52:57Z","timestamp":1763729577000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2077-0383\/14\/23\/8277"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,11,21]]},"references-count":13,"journal-issue":{"issue":"23","published-online":{"date-parts":[[2025,12]]}},"alternative-id":["jcm14238277"],"URL":"https:\/\/doi.org\/10.3390\/jcm14238277","relation":{},"ISSN":["2077-0383"],"issn-type":[{"value":"2077-0383","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,11,21]]}}}