May 22, 2025 A First: Slowing Alzheimer's Disease

How a New Medication Is Changing Treatment and Highlighting Expert Regional Care

Alzheimer’s disease continues to affect millions of lives, but recent advances in research and treatment are offering new hope for patients and their families.

A promising new drug approved by the U.S. Food and Drug Administration in 2023 is now available at Robert Wood Johnson University Hospital (RWJUH) in New Brunswick. Called Leqembi (lecanemab), it offers significant potential to slow progression of the disease. RWJUH is among the first in the region to offer Leqembi, which is available to patients diagnosed with mild cognitive impairment or mild dementia confirmed to be caused by Alzheimer’s disease, throughout the RWJBarnabas Health (RWJBH) system and beyond.

The new drug represents a crucial step forward in understanding and managing Alzheimer’s disease. It also highlights the importance of ongoing research and innovation in neurology, including at RWJUH, a neuroscience Center of Excellence.

Easing Progression

Leqembi is a monoclonal antibody that removes plaques from the brain that are thought to be a major contributor to Alzheimer’s. The drug is given twice monthly by intravenous infusion at the outpatient clinic in New Brunswick. It doesn’t cure Alzheimer’s (no cure is known), but slowing the disease can improve quality of life for patients and their loved ones.

“There have been many generations of drugs that could remove plaque but didn’t result in improvement in symptoms over time,” says William Hu, MD, PhD, FAAN, Associate Professor, Chief of Cognitive Neurology and Medical Director, Alzheimer’s Disease Clinic, Rutgers Robert Wood Johnson Medical School (RWJMS) and RWJUH; Director of the Center for Healthy Aging Research at the Rutgers Institute for Health, Health Care Policy and Aging Research; and a member of RWJBarnabas Health Medical Group. The latest generation of drugs, which includes Leqembi, can not only remove plaque but also slow declines in memory or thinking by about 25 percent, says Dr. Hu, who oversees administration of Leqembi throughout the RWJBH system. “That’s a fairly dramatic change,” he notes, “especially if you start early.” The drug’s impact is seen in patients about one to two years after treatment is started.

Effects on Life

Many of Dr. Hu’s Alzheimer’s patients want to know how they can maintain their quality of life after diagnosis—especially how they can remain in their homes as long as possible. Drugs like Leqembi, Dr. Hu says, “can really flatten the change over time. Instead of having five or six points of change over two years, you may only have three or four points of change.”

That can make a meaningful difference in people’s lives. “If you can delay the conversion from the very earliest stages to the next stages by five years, you essentially reduce the number of people with dementia [at a given time] by half,” Dr. Hu says. “It’s truly extending the quality of life for a longer period of time.”

Leqembi’s most common side effects include headache, infusion-related reactions and imaging abnormalities known to occur with antibodies that target the Alzheimer’s-related protein amyloid. These side effects can be managed by the expert team at the clinic.

What Is Alzheimer's Disease?

Alzheimer’s disease is the most common cause of dementia—marked by a specific, combined set of brain changes and cognitive decline—and affects an estimated 7 million Americans.

Dementia is generally considered to occur when a person experiences enough cognitive decline that it affects daily functioning, according to Dr. Hu.

A variety of tests, including written ones, help determine if someone has dementia or a milder form of cognitive impairment. Specialized spinal fluid tests or PET (positron emission tomography) scans can confirm that cognitive impairment is caused by Alzheimer’s.

Spinal fluid tests evaluate factors associated with Alzheimer’s such as the presence of amyloid plaque and tau tangles (abnormal protein structures in the brain that interfere with nerve function), along with brain cell loss/shrinkage and inflammatory responses to these changes. With the advent of effective medications such as Leqembi, spinal fluid tests and PET scans are now covered by a variety of insurance plans, including those from Medicare, Medicaid and Veterans Affairs.

While Alzheimer’s has no cure, multiple approaches can help manage its effects. These include lifestyle measures such as exercising, getting daytime light exposure to help keep the brain in a day/night pattern, managing stress and engaging in social/cognitive activities. Symptomatic medications can help improve day-to-day sharpness and memory but don’t slow cognitive decline—as new drugs such as Leqembi can.

Leaders in Alzheimer's Research and Care

Neurologists throughout RWJBarnabas Health (RWJBH) and outside providers statewide are referring patients to Robert Wood Johnson University Hospital (RWJUH) for groundbreaking treatment such as the medication Leqembi. Such referrals reflect how the Cognitive Neurology and Alzheimer’s Disease Clinic led by Dr. Hu is recognized for both Alzheimer’s treatment and research. The program’s accomplishments include:

• Collaboration among providers such as cognitive neurologists, neuropsychologists, geriatricians, nurse practitioners and genetic counselors to combine deep understanding of brain diseases, diverse assessments of brain function and broad expertise in overall health and care of older adults
• Leadership in using minimally invasive spinal fluid tests to provide early, accurate confirmation of changes related to Alzheimer’s disease and other forms of dementia
• Significant research, including studies funded by the National Institutes of Health (NIH) exploring mechanisms of Alzheimer’s disease such as inflammation and social determinants of health
• Investment in multicultural brain health, including clinical and research programs for Chinese and South Asian older adults—recognized by an NIH designation of RWJUH as the nation’s only Resource Center for Alzheimer’s and Dementia Research in Asian and Pacific Americans
• Pioneering research leading to the identification of:
  • A protective profile of inflammatory proteins in very mild Alzheimer’s disease that can be used in future prognostic tests
  • Molecular profiles distinguishing between Alzheimer’s and long COVID-19
  • Novel tests in Chinese people to detect early cognitive decline
  • A new way to identify dementia in older South Asians
  • Other tools used to personalize evaluation and treatment of memory disorders

To learn more about Leqembi, call the Alzheimer’s Disease Clinic at Rutgers RWJMS and RWJUH at 732-235-7733. Patients and caregivers can also schedule an appointment and begin the process of determining whether a patient qualifies to receive the therapy.