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An effective treatment for Alzheimer’s disease has long been a holy grail in the pharmaceutical industry. In early June, some hope appeared when the FDA agreed that the anti-amyloid antibody lecanemab (to be sold by Eisai as Leqembi) outperformed placebo in trials. It is expected to receive full approval by July 6.

But this may not necessarily be purely good news.

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On the latest episode of the “First Opinion Podcast,” physician and professor Jason Karlawish argues that lecanemab and other promising new drugs, such as donanemab, will introduce complicated issues into the field of Alzheimer’s care. These medications require a great deal of testing and patient monitoring, trained physicians, and other resources in a system that is already stretched thin.

“Dr. Karlawish’s dream of reason would be … a training module for physicians to learn the key things they need to learn and then self-assess their comfort with the drug,” Karlawish said. “But that’s Karlawish’s dream of reason in a world that seems increasingly less reasonable sometimes.”

Karlawish is a professor of medicine, medical ethics and health policy, and neurology at the University of Pennsylvania’s Perelman School of Medicine. The conversation is based off his recent First Opinion, “The FDA needs a risk evaluation and mitigation strategy for Alzheimer’s drug lecanemab.“

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