Donanemab Offers New Hope for Early Alzheimer's

Donanemab, the newly FDA-approved Alzheimer’s drug, offers monthly infusion treatment that slows early cognitive decline by targeting brain amyloid plaques.

Highlights:

FDA-approved donanemab offers monthly IV infusions for early-stage Alzheimer’s
Shown to slow cognitive decline by 27–29% in clinical trials
Requires amyloid testing and MRI monitoring to screen for possible side effects

Donanemab, recently approved by the FDA, offers new hope for patients in the early stages of Alzheimer’s disease—slowing memory loss by up to 29% over 18 months ().

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TOP INSIGHT

Did You Know?
Donanemab slows Alzheimer’s decline by up to 29% in early stages #AlzheimersTreatment #BrainHealth #medindia

A Major Breakthrough in Alzheimer’s Care

Alzheimer’s disease, a relentless condition that steals memory and independence, now has a powerful new opponent: donanemab (brand name Kisluna). This newly approved intravenous (IV) infusion therapy targets the biological root of Alzheimer's—amyloid plaque buildup in the brain—and offers measurable slowing of cognitive decline in its early stages.

In clinical trials, donanemab slowed disease progression by 29% compared to placebo over 18 months, enabling many patients to retain independence in daily living for longer.

While similar to lecanemab (Leqembi), an earlier FDA-approved infusion, donanemab introduces new possibilities in how Alzheimer’s can be managed—and potentially paused.

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How Donanemab Works

Donanemab is a monoclonal antibody designed to bind specifically to amyloid-beta plaques in the brain. These toxic clumps are believed to disrupt nerve cell communication, contributing to memory loss and cognitive dysfunction.

Once bound, the drug activates the body’s immune system to clear the plaques, thereby slowing the damage to brain cells.

Interestingly, donanemab targets a more advanced form of amyloid-beta, which may explain why many trial participants achieved sufficient plaque clearance after a few months—some were even able to stop the drug early while maintaining its benefits ().

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Who Is Eligible for Donanemab?

Donanemab is approved for people with mild cognitive impairment (MCI) or mild dementia due to Alzheimer’s disease, and who show confirmed amyloid buildup in the brain.

To qualify, patients must first undergo diagnostic testing:

Amyloid PET scan, or
Spinal fluid (CSF) analysis through a lumbar puncture

These tests confirm the presence of Alzheimer’s pathology and rule out other causes of memory loss.

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What to Expect: Dosing and Monitoring

IV infusion every 4 weeks
Treatment duration may be shorter than 18 months if sufficient plaque clearance is achieved
Regular brain MRIs to monitor for side effects

This monthly schedule offers greater convenience than some earlier therapies that require biweekly infusions.

Understanding the Risks: What Is ARIA?

Like other amyloid-targeting drugs, donanemab carries the risk of amyloid-related imaging abnormalities (ARIA)—a condition involving brain swelling, small bleeds, or fluid leaks. It’s more common in people with the APOE ε4 gene variant.

21.5–40% of patients in clinical trials developed ARIA, though most cases were mild and asymptomatic.

Due to these risks, patients undergo genetic testing for APOE variants and receive MRI scans before and during treatment.

How Does Donanemab Compare to Lecanemab?

While both drugs slow early Alzheimer’s and target amyloid plaques, donanemab stands out in several ways:

Less frequent dosing (monthly vs. biweekly)
Possibility of early treatment completion
Slightly higher risk of ARIA, especially in APOE ε4 carriers

Lecanemab is currently available at the UW Memory and Brain Wellness Center, while donanemab, though approved, is not yet in clinical use at the center.

What’s the Controversy?

Some experts question whether the modest benefits of amyloid-clearing therapies justify the cost, risks, and ongoing monitoring involved. Long-term impacts, including reports of brain shrinkage, remain under investigation.

Medicare coverage requires participation in a clinical evidence registry, ensuring real-world data helps shape future use and policy.

Donanemab represents a significant advance in Alzheimer’s treatment. While not a cure, it offers real progress in preserving memory, autonomy, and quality of life—especially when diagnosed early. As research continues, this drug may pave the way for even more refined, personalized approaches to Alzheimer’s care. For now, it brings hope—turning what once felt inevitable into something that can be managed.

Every moment matters—if you suspect the early signs of Alzheimer’s, act now, because the chance to preserve memories begins with timely care and courageous hope.

References:

UW Medicine offers second drug for early Alzheimer's - (https://depts.washington.edu/mbwc/news/article/uw-medicine-offers-second-drug-for-early-alzheimers)
Amyloid-Clearing Infusion Treatments for Early-Stage Alzheimer's Disease Resource Page - (https://depts.washington.edu/mbwc/resources/lecanemab-leqembi-update)

Source-Medindia