Lecanemab (Leqembi®) and Donanemab (Kisunla®) are treatment options for selected patients with
early Alzheimer’s disease or mild cognitive impairment (MCI) due to Alzheimer’s disease.
We assess whether these treatments are appropriate and explain the expected course, risks, and monitoring requirements.
About these treatments
Lecanemab (Leqembi®)
- Intravenous infusion every two weeks
- Targets amyloid plaques in the brain
- Used in early Alzheimer’s disease and MCI due to Alzheimer’s disease
Donanemab (Kisunla®)
- Intravenous infusion once per month
- Also targets amyloid plaques
- Treatment duration may vary depending on response
Both treatments require regular hospital visits for infusion and monitoring.
This should be considered in advance, particularly for patients travelling from overseas.
Who may be considered
- Early-stage symptoms consistent with Alzheimer’s disease
- MCI due to Alzheimer’s disease or mild Alzheimer’s dementia
- Evidence of amyloid pathology (e.g., amyloid PET or equivalent)
- Able to attend scheduled infusion and monitoring visits
- Support from a caregiver or family member is recommended
Eligibility is determined individually. These treatments are not suitable for all patients with memory symptoms.
Monitoring and safety
Treatment requires regular monitoring.
One important consideration is ARIA (amyloid-related imaging abnormalities),
which is assessed using MRI.
- MRI is required before starting treatment
- Follow-up MRI and clinical review are performed during treatment
- Patients are advised on symptoms that require urgent assessment
The monitoring schedule is determined based on clinical findings and safety considerations.
At your evaluation
We review symptoms, medical history, medications, and prior investigations.
Cognitive assessment and neurological examination are performed,
and we confirm whether amyloid pathology has been demonstrated or needs evaluation.
If additional testing is required, we explain the process and arrange scheduling.
See Alzheimer’s-related testing for details.
Next steps
If treatment is appropriate, we explain the treatment plan,
monitoring schedule, and follow-up arrangements.
If these treatments are not suitable, alternative management and follow-up will be discussed.
Appointment
Appointments are required in principle. A referral letter from another medical institution is recommended but not mandatory.
Please bring any relevant records if available (prior cognitive testing, MRI/CT reports, amyloid PET report if already performed,
medication list, and a brief clinical summary from your doctor if possible).
For appointment requests and language support, please see the
Neurology page.