Multiple Cerebral Hemorrhages in a Patient Receiving Lecanemab and Treated with t-PA for Stroke

Reish, Nicholas J.; Jamshidi, Pouya; Stamm, Brian; Flanagan, Margaret E.; Sugg, Elizabeth; Tang, Mengxuan; Donohue, Kelly L.; McCord, Matthew; Krumpelman, Chase S.; Mesulam, Marek-Marsel; Castellani, Rudolph J.; Chou, Sherry

doi:10.1056/nejmc2215148

Cited by 75 publications

(39 citation statements)

References 2 publications

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“…Taken together these data suggested less efficient coagulation and increased fibrinolysis in systemic amyloidosis [ 165 ]. Iatrogenic tPA-mediated severe haemorrhagic strokes was recently implicated as a combinatorial side effect of the novel Aβ-protofibril targeting Lecanemab antibody [ 170 ]. The progression and the extent of the haemorrhage of the afflicted patient were rapid.…”

Section: Amyloidogenesis Abnormal Blood Clotting and Fibrinolysis In ...mentioning

confidence: 99%

Viruses and amyloids - a vicious liaison

Hammarström

Nyström

2023

Prion

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The crosstalk between viral infections, amyloid formation and neurodegeneration has been discussed with varying intensity since the last century. Several viral proteins are known to be amyloidogenic. Post-acute sequalae (PAS) of viral infections is known for several viruses. SARS-CoV-2 and COVID-19 implicate connections between amyloid formation and severe outcomes in the acute infection, PAS and neurodegenerative diseases. Is the amyloid connection causation or just correlation? In this review we highlight several aspects where amyloids and viruses meet. The evolutionary driving forces that dictate protein amyloid formation propensity are different for viruses compared to prokaryotes and eukaryotes, while posttranslational endoproteolysis appears to be a common mechanism leading up to amyloid formation for both viral and human proteins. Not only do human and viral proteins form amyloid irrespective of each other but there are also several examples of co-operativity between amyloids, viruses and the inter-, and intra-host spread of the respective entity. Abnormal blood clotting in severe and long COVID and as a side effect in some vaccine recipients has been connected to amyloid formation of both the human fibrin and the viral Spike-protein. We conclude that there are many intersects between viruses and amyloids and, consequently, amyloid and virus research need to join forces here. We emphasize the need to accelerate development and implementation in clinical practice of antiviral drugs to preclude PAS and downstream neurological damage. There is also an ample need for retake on suitable antigen targets for the further development of next generation of vaccines against the current and coming pandemics.

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Section: Amyloidogenesis Abnormal Blood Clotting and Fibrinolysis In ...mentioning

confidence: 99%

Viruses and amyloids - a vicious liaison

Hammarström

Nyström

2023

Prion

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“…There was no excess mortality during the 18-month double-blind period of the trial, but in the subsequent open-label extension phase, three affected individuals had brain hemorrhage-related deaths that could be attributed to lecanemab treatment combined with anticoagulant therapies. 2 …”

Section: Main Textmentioning

confidence: 99%

Lecanemab reduces brain amyloid-β and delays cognitive worsening

Knopman¹

2023

Cell Reports Medicine

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“…Concerns have been raised about deaths of patients in extension studies for lecanemab that are thought to be related to the drug 3. A letter published in response to the study reports a case of numerous acute intracerebral haemorrhages that developed after treatment with intravenous tissue plasminogen activator for acute ischaemic stroke syndrome in a patient who received three doses of intravenous lecanemab 4. The US organisation Public Citizen urged the US Food and Drug Administration (FDA) to delay making a decision on licensing lecanemab to allow more time for the evidence to be discussed by an advisory committee 3.…”

Section: Contextmentioning

confidence: 99%

Evidence for lecanemab in early Alzheimer’s disease

2023

DTB

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Multiple Cerebral Hemorrhages in a Patient Receiving Lecanemab and Treated with t-PA for Stroke

Cited by 75 publications

References 2 publications

Viruses and amyloids - a vicious liaison

Viruses and amyloids - a vicious liaison

Lecanemab reduces brain amyloid-β and delays cognitive worsening

Evidence for lecanemab in early Alzheimer’s disease

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