Happy & Healthy with Amy

Do Leqembi and Kisunla Work? The 2 Key Factors

• Amy Lang • Season 2 • Episode 54

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0:00 | 33:06

If your mom or dad has been diagnosed with mild cognitive impairment or early Alzheimer’s disease, you may suddenly be facing a decision you never expected to make: Should they take Leqembi or Kisunla?

And if you’ve already read headlines saying anti-amyloid drugs offer little to no clinically meaningful benefit, that decision gets even more confusing.

In this episode, I’m taking a closer look at the newer FDA-approved Alzheimer’s drugs—specifically lecanemab and donanemab—and an important question that can get lost when we look only at the averages: Does the stage of Alzheimer’s disease and the amount of tau already in the brain change how well these treatments work?

The answer appears to be yes.

In Part 1 of this three-part series, I’ll walk you through the evidence, explain why tau may be one of the most important pieces of this conversation, and help you understand who appears most likely to benefit from the newest Alzheimer’s treatments.

WHAT TO LISTEN FOR:

  • [00:00] The question families face after an MCI or early Alzheimer’s diagnosis?
  • [03:39] Why the conclusion from the Cochrane review deserves another look
  • [05:47] Why pooling data may hide an important treatment signal.
  • [09:06] The main criticism of the Cochrane review
  • [15:48] Why “early is everything” when it comes to Alzheimer’s treatment
  • [15:00] Amyloid vs. tau explained 
  • [20:12] Why removing amyloid may have far less impact once tau levels are high
  • [26:46] What the donanemab data shows when researchers separate people based on their tau burden and stage of disease.
  • [27:17] What the lecanemab data really says
  • [29:57] The two questions Amy recommends asking a neurologist before deciding

The biggest takeaway from this episode isn’t that the Cochrane review was “wrong.” It’s that averages can hide important differences between patients.

In Part 2, we’re talking about the risks, including ARIA, brain swelling and bleeding, and the factors that may make someone more vulnerable.

Listen to the episode, subscribe to Happy & Healthy with Amy, and share this series with someone who is trying to make sense of an Alzheimer’s diagnosis and treatment options.

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