How do they work?
These laboratory-engineered antibodies bind to aggregated beta-amyloid and help the body clear plaques that are a hallmark of Alzheimer’s disease. By lowering plaque burden, they aim to slow worsening of memory and thinking over time.
Treatment
The very first step is a consultation with a Salma Health neurologist or memory-care specialist to confirm whether anti-beta-amyloid therapy is appropriate.
Step 1: Initial evaluation
- Comprehensive memory and cognitive testing.
- Review of medical history and current medications.
- Confirm beta-amyloid pathology (e.g., amyloid PET or CSF) and obtain a baseline brain MRI for safety.
- Discuss APOE ε4 genetic testing (recommended before starting Leqembi to inform ARIA risk) and overall ARIA risk counseling.
Step 2: Therapy setup & dosing
If treatment is appropriate, we create an individualized plan:
- Leqembi: IV infusion every 2 weeks for 18 months (about 1 hour per infusion). After 18 months, continue every 2 weeks or transition to maintenance: monthly IV (10 mg/kg q4w) or weekly at-home subcutaneous injections (360 mg with the LEQEMBI IQLIK autoinjector).
- Kisunla: IV infusion every 4 weeks (about 30 minutes) with an initial dose-titration schedule. Clinicians may consider stopping Kisunla when amyloid PET shows plaques reduced to minimal levels; monitoring continues and treatment can be revisited if needed.
Step 3: Treatment sessions (infusion and/or injection)
- IV infusions are provided in a comfortable clinical setting; plan on infusion time plus brief observation.
- If you transition to Leqembi weekly injections, we train you or a care partner on safe at-home administration.
- We watch for possible side effects (e.g., infusion reactions).
Step 4: Ongoing safety monitoring
- MRI monitoring for ARIA (amyloid-related imaging abnormalities) is required early in treatment:
- Leqembi: baseline MRI, then MRIs before the 3rd, 5th, 7th, and 14th infusions.
- Kisunla: baseline MRI, then MRIs before the 2nd, 3rd, 4th, and 7th infusions.
- Additional MRIs are obtained if symptoms suggest ARIA. APOE ε4 carriers—especially homozygotes—have higher ARIA risk, which we discuss and plan for.
- Regular clinical follow-ups assess cognition and overall response, and we adjust the care plan as needed.
Step 5: Supportive care
Treatment is combined with memory care, counseling, and caregiver support. Salma Health provides a holistic approach to brain health alongside disease-modifying therapy.
Getting started
If you or a loved one has been diagnosed with early Alzheimer’s disease, we can guide you through confirming eligibility, choosing between Leqembi and Kisunla and setting up a safe, personalized treatment plan.
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