Kang Sung Hoon, Jeong Jee Hyang, Pyun Jung-Min, Kim Geon Ha, Park Young Ho, Shim YongSoo, Koh Seong-Ho, Kim Chi-Hun, Youn Young Chul, Yang Dong Won, Lee Hyuk-Je, Lee Han, Kim Dain, Sun Kyunghwa, Moon So Young, Park Kee Hyung, Choi Seong Hye
Department of Neurology, Korea University Guro Hospital, Korea University College of Medicine, Seoul, Korea.
Department of Neurology, Ewha Womans University Seoul Hospital, Ewha Womans University College of Medicine, Seoul, Korea.
J Clin Neurol. 2025 May;21(3):182-189. doi: 10.3988/jcn.2024.0550.
We aimed to determine the proportion of Korean patients with early Alzheimer's disease (AD) who are eligible to receive lecanemab based on the United States Appropriate Use Recommendations (US AUR), and also identify the barriers to this treatment.
We retrospectively enrolled 6,132 patients with amnestic mild cognitive impairment or mild amnestic dementia at 13 hospitals from June 2023 to May 2024. Among them, 2,058 patients underwent amyloid positron emission tomography (PET) and 1,199 (58.3%) of these patients were amyloid-positive on PET. We excluded 732 patients who did not undergo brain magnetic resonance imaging between June 2023 and May 2024. Finally, 467 patients were included in the present study.
When applying the criteria of the US AUR, approximately 50% of patients with early AD were eligible to receive lecanemab treatment. Among the 467 included patients, 36.8% did not meet the inclusion criterion of a Mini-Mental State Examination (MMSE) score of ≥22.
Eligibility for lecanemab treatment was not restricted to Korean patients with early AD except for those with an MMSE score of ≥22. The MMSE criteria should therefore be reconsidered in areas with a higher proportion of older people, who tend to have lower levels of education.
我们旨在根据美国合理使用建议(US AUR)确定符合接受乐卡奈单抗治疗的韩国早期阿尔茨海默病(AD)患者比例,并找出该治疗的障碍。
我们回顾性纳入了2023年6月至2024年5月期间13家医院的6132例遗忘型轻度认知障碍或轻度遗忘型痴呆患者。其中,2058例患者接受了淀粉样蛋白正电子发射断层扫描(PET),其中1199例(58.3%)患者PET检查显示淀粉样蛋白呈阳性。我们排除了2023年6月至2024年5月期间未进行脑磁共振成像的732例患者。最终,467例患者纳入本研究。
应用US AUR标准时,约50%的早期AD患者符合接受乐卡奈单抗治疗的条件。在纳入的467例患者中,36.8%未达到简易精神状态检查表(MMSE)评分≥22的纳入标准。
除MMSE评分≥22的患者外,乐卡奈单抗治疗的资格不限于韩国早期AD患者。因此,在老年人比例较高、教育水平往往较低的地区,应重新考虑MMSE标准。