Estimating the eligible population for amyloid-targeting monoclonal antibody therapy in memory clinics: Application to lecanemab in France.
4 affiliations
- 1University Bordeaux, Inserm, Bordeaux Population Health, Bordeaux, UMR1219, France; CIC 1401 EC, Pôle Santé Publique, CHU de Bordeaux, France. Electronic address: [email protected].
- 2University Bordeaux, Inserm, Bordeaux Population Health, Bordeaux, UMR1219, France; CIC 1401 EC, Pôle Santé Publique, CHU de Bordeaux, France.
- 3University Bordeaux, Inserm, Bordeaux Population Health, Bordeaux, UMR1219, France.
- 4University Bordeaux, CNRS, Institut des Maladies Neurodégénératives, Bordeaux, UMR 5293, France; Pôle de Neurosciences Cliniques, Centre Mémoire de Ressources et de Recherche, CHU de Bordeaux, France.
Abstract
Lecanemab was the first amyloid-targeting monoclonal antibody approved by the European Commission for treating patients with mild cognitive impairment (MCI) and mild dementia due to Alzheimer's disease (AD). While this marketing authorization led to heterogeneous situations across European countries, France declined reimbursement, citing limited clinical benefit and concerns about the healthcare system's capacity to implement this new care pathway. This capacity depends directly on the number of eligible patients, yet robust estimates remain limited and highly variable across studies. Our objective was therefore to estimate the population eligible for lecanemab in France. Using transportability methods based on inverse odds of selection weighting, we articulated the nationwide consultation data from the French National Alzheimer Database (BNA) with the deeply phenotyped MEMENTO clinical cohort. Eligibility for lecanemab followed the French appropriate use recommendations: 1) clinical eligibility (age 50-90 years, MCI with common AD phenotype or mild AD dementia, MMSE ≥22), 2) biological eligibility (amyloid confirmation determined sequentially using plasma p-tau217, cerebrospinal fluid biomarkers and amyloid-PET), 3) absence of contraindications (APOEε4 homozygosity, anticoagulant use, MRI risk markers for ARIA). Among patients consulting French memory clinics, 19.5% met clinical eligibility criteria. Of these, 73.0% (95%CI: 67.6-77.9) were amyloid-positive, and 49.7% (95%CI: 44.0-55.5) remained eligible after applying safety criteria. Overall, 9.7% (95%CI: 8.6-10.8) of patients consulting memory clinics were estimated to be eligible for lecanemab, representing approximately 18,200 individuals nationally (annual average, 2022-2024). These results inform healthcare planning for disease-modifying therapy implementation in France and comparable countries.
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BibTeX
@article{scouarnec2026estimating,
title = {{Estimating the eligible population for amyloid-targeting monoclonal antibody therapy in memory clinics: Application to lecanemab in France.}},
author = {Lisa Le Scouarnec and Vincent Bouteloup and Leslie Grasset and Vincent Planche and Geneviève Chêne and Carole Dufouil and MEMENTO Study Group},
journal = {The journal of prevention of Alzheimer's disease},
year = {2026},
month = oct,
doi = {10.1016/j.tjpad.2026.100683},
url = {https://europepmc.org/article/MED/42874425},
note = {CC BY-NC-ND},
}
RIS
TY - JOUR
TI - Estimating the eligible population for amyloid-targeting monoclonal antibody therapy in memory clinics: Application to lecanemab in France.
AU - Lisa Le Scouarnec
AU - Vincent Bouteloup
AU - Leslie Grasset
AU - Vincent Planche
AU - Geneviève Chêne
AU - Carole Dufouil
AU - MEMENTO Study Group
PY - 2026
DA - 2026/10/14
JO - The journal of prevention of Alzheimer's disease
DO - 10.1016/j.tjpad.2026.100683
UR - https://europepmc.org/article/MED/42874425
AB - Lecanemab was the first amyloid-targeting monoclonal antibody approved by the European Commission for treating patients with mild cognitive impairment (MCI) and mild dementia due to Alzheimer's disease (AD). While this marketing authorization led to heterogeneous situations across European countries, France declined reimbursement, citing limited clinical benefit and concerns about the healthcare system's capacity to implement this new care pathway. This capacity depends directly on the number of eligible patients, yet robust estimates remain limited and highly variable across studies. Our objective was therefore to estimate the population eligible for lecanemab in France. Using transportability methods based on inverse odds of selection weighting, we articulated the nationwide consultation data from the French National Alzheimer Database (BNA) with the deeply phenotyped MEMENTO clinical cohort. Eligibility for lecanemab followed the French appropriate use recommendations: 1) clinical eligibility (age 50-90 years, MCI with common AD phenotype or mild AD dementia, MMSE ≥22), 2) biological eligibility (amyloid confirmation determined sequentially using plasma p-tau217, cerebrospinal fluid biomarkers and amyloid-PET), 3) absence of contraindications (APOEε4 homozygosity, anticoagulant use, MRI risk markers for ARIA). Among patients consulting French memory clinics, 19.5% met clinical eligibility criteria. Of these, 73.0% (95%CI: 67.6-77.9) were amyloid-positive, and 49.7% (95%CI: 44.0-55.5) remained eligible after applying safety criteria. Overall, 9.7% (95%CI: 8.6-10.8) of patients consulting memory clinics were estimated to be eligible for lecanemab, representing approximately 18,200 individuals nationally (annual average, 2022-2024). These results inform healthcare planning for disease-modifying therapy implementation in France and comparable countries.
SN - 2426-0266
ER -