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The Food and Drug Administration (FDA) has approved two new therapies, lecanemab and donanemab, for the treatment of Alzheimer’s disease at the earliest symptomatic states. These medications are two of the first disease-modifying therapies approved for the treatment of Alzheimer’s disease in the United States.
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Antiamyloid therapies are medications designed to remove a protein called beta-amyloid from the brain. This protein is thought to be involved in the development and progression of Alzheimer’s disease.
Lecanemab is a monoclonal antibody targeting beta-amyloid, which can form plaques in the brain and interfere with brain function. Lecanemab removes beta-amyloid and can slow the progress of Alzheimer’s disease by about 30%.
Donanemab is a monoclonal antibody targeting beta-amyloid, which can form plaques in the brain and interfere with brain function. Donanemab removes beta-amyloid and can slow the progress of Alzheimer’s disease by about 30%.
The medications are given through a vein (intravenously). Lecanemab is given every two weeks, and donanemab is given every four weeks. IV infusions are administered at Norton Infusion Centers locations downtown and on the Norton Brownsboro Hospital campus.
Lecanemab and donanemab are indicated for patients in the mild or early stage of Alzheimer’s disease. An assessment of medical history, an MRI scan, bloodwork, spinal fluid examination or an amyloid positron-emission tomography scan maybe required to determine whether lecanemab or donanemab are appropriate for you. A genetic test can determine the risk of side effects such as brain swelling or bleeding (amyloid-related imaging abnormalities, or ARIA).
If you think you are eligible for lecanemab or donanemab, talk to your primary care provider, neurologist or memory care provider. Your provider can make a referral to the Norton Neuroscience Institute Memory Center to determine whether you are eligible.
Previously available medications treat only the symptoms of Alzheimer’s disease. Lecanemab and donanemab are the first of a new class of medications known as antiamyloid therapies that are thought to target an underlying cause of Alzheimer’s disease and slow its progression.
– Infusion reactions: Symptoms might include fever, headache, rash, nausea or abdominal discomfort. These symptoms usually can be controlled with medications such as Tylenol or Benadryl, if necessary.– Amyloid-related imaging abnormalities: ARIA is a condition that indicates swelling or bleeding in the brain. Most often, this causes no symptoms and resolves without any treatment. However, more severe cases can occur, leading to symptoms such as headache, confusion, visual changes, dizziness, nausea and seizures. In rare cases, this can lead to death.Because of the risk of bleeding, this medication is not recommended for patients taking strong blood thinners. Also, those receiving lecanemab should not receive clot-busting medications.
Lecanemab and donanemab are given intravenously in an infusion center. The infusion takes less than an hour, with a period of monitoring for reactions after. Repeat MRI scans can be completed three to four times during the first year to monitor for any side effects.
Antiamyloid therapies will not improve memory but appear to slow the progression of Alzheimer’s disease. The goal is that individuals receiving this medication will retain their memory and cognitive function longer.Ultimately, the FDA approval of these drugs makes the treatments more accessible to patients through Medicare, Medicaid and private insurance. As more patients are prescribed the drug, more research and clinical trials can advance the treatment of Alzheimer’s disease. Eradication of the disease is the hope.“I think it is a very significant step forward for our field. It’s the first time that we have had a medication with very solid evidence that it is really modifying the course of this disease and, at least as many of us think, treating the underlying causes of this disease.” – Gregory E. Cooper, M.D., Ph.D., director, Norton Neuroscience Institute Memory Center
Lecanemab and donanemab are both approved by the FDA and currently covered by Medicare. Coverage from private insurance plans can vary. If you have questions, contact your insurance carrier.
Reviewed by Gregory E. Cooper, M.D., Ph.D., director, Norton Neuroscience Institute Memory Center
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