Novel Approaches to Treatment ​​​​​​​

​We're excited to share information about a new approach to treating Alzheimer's disease with infusion therapies with Lequenbi and Kisunla. These treatments are different from older medications that only helped manage symptoms. Instead, they target the disease itself by addressing amyloid plaques, which are a key feature of Alzheimer's in the brain. These therapies are considered "disease-modifying," meaning they aim to slow down the progression of the disease.​​

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How Do These Infusion Therapies Work?

These therapies use medications called monoclonal antibodies, which are delivered directly into your bloodstream through an IV (intravenous) infusion. They are specifically designed for individuals in the early stages of Alzheimer's – those with Mild Cognitive Impairment or mild dementia.

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Important Points to Keep in Mind:

• Not a Cure, But Slows Decline: While these infusions aren't a cure for Alzheimer's, clinical trials have demonstrated that they can slow down the rate of cognitive decline by approximately 27% to 35% over 18 months.

• More Independent Time: This slowing of decline can translate to a meaningful difference in daily life. For many, it could mean roughly 6–10 additional months of living independently and maintaining important daily functions, such as managing finances or driving.

• Early Intervention is Key: These treatments are most effective in the early stages of Alzheimer's. Unfortunately, they are not recommended for individuals with moderate or severe stages of the disease.

• Maintenance Phase: For Leqembi, the FDA approved a maintenance phase in 2025. This allows patients who have cleared the plaques in their brain to switch to less frequent infusions (monthly) or even a convenient once-weekly at-home subcutaneous injection (Leqembi IQLIK™).

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Important Monitoring: Understanding ARIA

​A potential side effect of these therapies is ARIA (Amyloid-Related Imaging Abnormalities). ARIA is usually detected through routine MRI scans, and in most cases, it doesn't cause any noticeable symptoms. However, in some instances, ARIA can be serious or even life-threatening. Because of this risk, patients undergoing infusion therapy will need to have regular MRI scans to monitor their brain health. The frequency is often 4–5 times in the first year.

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Who is Eligible for These Infusion Therapies?

To determine if these infusions are right for you, several factors are considered:

1. Confirming Amyloid Presence: It's essential to confirm the presence of amyloid plaques in the brain. This is typically done through a PET scan or a lumbar puncture (spinal tap).

2. Genetic Testing: Testing for the APOE ε4 gene is recommended because carrying this gene increases the risk of developing ARIA.

3. Insurance Coverage: Medicare now covers these drugs if your doctor participates in a registry to track long-term outcomes. You will likely be responsible for a 20% coinsurance payment after meeting your deductible. Contact your insurance provider for more information.

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Does Direct Neurology Provide this type of therapy? ​

Dr. Sadikovic is one of the few neurologists in the East Bay offering this therapy that could benefit you or your loved one. If you want to find out if this therapy is the right choice for you, we invite you to schedule an initial evaluation visit with Dr. Sadikovic. If this therapy is recommended for you, we will work closely with various infusion centers to arrange your treatment seamlessly. 

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Infusion Centers near you:

• Contra Costa Oncology - Walnut Creek, Shadelands

• IVX Health Infusion Center - Walnut Creek, Shadelands

• AleraCare Infusion Center - Berkeley

• IVX Health Center - San Ramon

• MedLounge - San Ramon

• IVX Health Infusion Center - Danville

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