Aducanumab

Posted On July 24, 2021
  • approved by FDA for mild Alzheimer’s disease: uncertain as to which patients may benefit
  • A recombinant monoclonal antibody
  • reduce amyloid plaque on pet imaging
  • Coverage: not covered by public & private payers
    • Cost: about $60,000 per year, depends on weight
  • inconsistant clinical effects on rating scales

Dosing

  • MRI brain
  • Week 1 then week 2: 1 mg/kg iv over 1 hour
  • Week 8 then week 16: 3 mg/kg iv over 1 hour
  • Week 24 then week 32: 6 mg/kg over 1 hour
  • MRI brain required
  • Week 36 and on: 10 mg/kg iv over 1 hour

Side Effects

  • headache, confusion, falls, diarrhea
  • focal neuro deficit
  • ARIA: Amyloid related imaging abnormalities
    • 40% treated with the highest dose. Amyloid related imaging abnormalities
      • edema and or microhemorrhages
      • most common within the first 8 doses
      • 70% are asymptomatic

References

Uptodate

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