News
Video
Philip Kuball, MD, neurology resident at NYU Langone Health, highlights the integral role of pharmacists in monitoring patient eligibility, managing dosing schedules, and ensuring safe medication interactions for lecanemab treatment in Alzheimer disease.
In an interview with Pharmacy Times®, Philip Kuball, MD, resident at the Department of Neurology at NYU Langone Health, discussed the abstract he presented during the "Innovations in Dementia Treatment" session at the American Academy of Neurology (AAN) 2025 Annual Meeting in San Diego, California, which took place from April 5 to April 9. The study, led by Kuball and others, featured a committee of 5 neurologists practicing at the NYU Langone Pearl Barlow Center for Memory Evaluation & Treatment, established to review all patients with early Alzheimer disease (AD) recommended for lecanemab (Leqembi; Eisai) therapy within the NYU Langone Healthcare system.
Kuball's review of patient outcomes found that cognitive decline slowed meaningfully over the first 9 months of lecanemab treatment. Kuball emphasized the crucial role pharmacists play in patient care with lecanemab. He explained that pharmacists are essential in monitoring dosing schedules, checking for potential drug interactions, and identifying patients who might benefit from the treatment.
Pharmacy Times: Could you elaborate on the role of pharmacists in monitoring and managing patients undergoing lecanemab therapy?
1. Pharmacists are critical in monitoring patient eligibility, managing dosing, and checking for potential drug interactions with lecanemab.
2. There are specific exclusion criteria for lecanemab, including patients on anticoagulants or with active cancer.
3. Early diagnosis of mild cognitive impairment is now incentivized due to the availability of disease-modifying therapies like lecanemab.
Philip Kuball, MD: Pharmacists are integral to the process in our committee. They help with dosing and with dosing schedules, and they make sure that there are no drug-to-drug interactions with other medications patients may be on. Overall, they've really helped with the entire treatment protocol in general, and that's been really important for the committee.
Pharmacy Times: What strategies should pharmacists employ to ensure timely identification and referral of patients who might benefit from this treatment?
Kuball: I think pharmacists, if they do see patients that are on other dementia medications like anticholinesterase inhibitors or memantine or something, that might clue them in to tell the patient to ask their neurologist if they may be considered for a medication like lecanemab.
Pharmacy Times: Considering the exclusion criteria, such as the use of anticoagulants and the presence of active cancer, what considerations should pharmacists keep in mind when reviewing a patient's medical profile and medical history prior to lecanemab initiation?
Kuball: For the Barlow Lecanemab Review Committee, the patients are actually—that's part of the exclusion criteria. Like you mentioned, they're already expected to not be on anticoagulation or immunomodulatory therapies. They're expected to not have active cancer. At that point, there shouldn't be a question of 'Hey, lecanemab, is it going to interact with blood thinners or anything?' because in order to receive it through our committee, they can't be taking those medications. But I will add, from the community perspective, on a larger scale, if a pharmacist notices that one of their patients is on lecanemab but is also on anticoagulation or is being treated for cancer, that should clue them in that those interactions could potentially be unsafe. At that point, they should step in and consider talking to the physician about discontinuing the medications.
Pharmacy Times: Is there anything else that you wanted to add?
Kuball: This is a really exciting time for dementia care, for AD care. I'm excited to be kind of venturing in as a trainee at this time. In my experience, again, I'm excited, but like I said earlier, we have a lot of data collection to go and a lot of questions to answer. But nonetheless, I think it's a time when we can afford to be excited and hopeful. Additionally, now there's incentive to be diagnosed early, at an early mild cognitive impairment stage or mild dementia stage, because there's disease-modifying therapy.
