Alzeimer's Disease
Leqembi (lecanemab) & Kisunla (donanemab)
The cause of Alzheimer’s Disease and its progression may be related to the amount of an abnormal protein found in the brains of patients with AD. That protein is prone to clump together to form protein aggregates called amyloid plaques. These aggregates are the most common pathology seen in the brains of patients with AD. We can image these plaques using amyloid PET imaging methods. An abnormal amyloid PET scan is now required to make the diagnosis of AD. Recent FDA approval of two treatments targeting the amyloid plaques have been approved showing a statistically significant slowing of progression of dementia in patients with mild cognitive decline compared to placebo.
The FDA approved two treatments for patients with mild cognitive decline due to Alzheimer’s Disease. The first is Lecanemab (Leqembi). Lecanemab is a monoclonal antibody given intravenously that targets the beta amyloid protein preventing its deposition into aggregates. It is administered intravenously every 2 weeks. The most common side effects are headache, infusion related reactions and amyloid-related imaging abnormalities (ARIA).
The most recent treatment to be approved is donanemab (Kisunla), which is also a monoclonal antibody that attacks the amyloid protein. However, it is more targeted to the completed amyloid plague. This is given intravenously as well but every month. Side effects may include infusion-related reactions, with symptoms such as flu-like symptoms, nausea, vomiting and changes in blood pressure, and hypersensitivity reactions, including anaphylaxis (severe, life-threatening allergic reaction) and angioedema (swelling). Amyloid related imaging abnormalities (ARIA) are also risk events.
At Lange Neurology, PC we have experience in identifying patients who qualify for treatment and administering both medications.