New Biogen CEO tips subcutaneous lecanemab to help expansion into pre-symptomatic Alzheimer's

New Biogen CEO Chris Viehbacher has set out plans for a subcutaneous version of lecanemab, outlining how changing the delivery method of the Eisai-partnered Alzheimer’s disease drug could be particularly valuable for pre-symptomatic patients.

Lecanemab recently won accelerated approval in the U.S., positioning Biogen and Eisai to sell the drug as Leqembi. The monoclonal antibody is administered intravenously once every two weeks. While working to show that lecanemab improves outcomes when given intravenously, Eisai also began testing the effect of a subcutaneous formulation on healthy volunteers. 

Viehbacher discussed the subcutaneous program at the J.P. Morgan Healthcare Conference, telling the analysts that Biogen and Eisai are taking a “multipronged approach” to the project but demurring on the question of when the formulation could come to market.

The newly installed Biogen CEO was more forthcoming on what subcutaneous delivery could mean for patients. As Viehbacher sees things, “the biweekly infusion is not necessarily the burden you might think it is,” because “sometimes this is a way of getting out of the house and getting some outside contact for patients.” Studies have shown social interaction improves the well-being of people with Alzheimer’s.

Even so, Viehbacher said “obviously, a [subcutaneous formulation] would be better.” The full value of the subcutaneous formulation may only be realized if Eisai and Biogen succeed in developing lecanemab for earlier-stage patients who are more likely to find biweekly infusions a major imposition on their lives. 

“We have a study ongoing … that is looking at pre-symptomatic patients. So, if you go earlier, are you going to get an even bigger benefit? If you did get success there, then I think actually subcu would be particularly important. But we're also looking at different dosing regimens. Clearly, we have to make sure that we can make this as convenient for the patient as possible,” Viehbacher said.