The Alzheimer's Disease Treatment Clinic helps people with early symptoms of Alzheimer's disease decide whether they might benefit from new drugs to slow down the condition. The clinic is available through the Neurology Department at Mayo Clinic in Rochester, Minnesota. Alzheimer's clinics will open at Mayo Clinic in Scottsdale, Arizona, and Jacksonville, Florida, in the future.
About the new Alzheimer's treatment drug
In 2023 the FDA approved a new Alzheimer's treatment drug called lecanemab (Leqembi). This medication is for use only in the earliest stages of Alzheimer's disease, which are also called mild cognitive impairment and mild dementia. When similar drugs were tested later in the disease course, there was no clinical benefit, but the risks remained. Other similar medications may be approved over time.
Lecanemab is injected into the bloodstream and removes a protein in the brain called amyloid. This treatment is not a cure for Alzheimer's disease. But it can help slow the rate of disease progression so that people retain brain function longer. The medication needs to be injected twice a month.
A team approach to personalized care
The team at the Alzheimer's Disease Treatment Clinic uses a thorough multidisciplinary approach. Team members come together early in your care journey to help you make treatment decisions based on your needs and goals.
The clinic team is made up of specialists from several areas, including cognitive and behavioral neurology, radiology, infusion therapy, neuropsychology, geriatrics, and genetics. Your care team listens to your concerns and questions, assesses your needs, and develops a care plan tailored to you.
Advanced diagnostic tools for Alzheimer's
Your health care team might have you undergo tests to learn whether you might benefit from the new medications. An evaluation in the Alzheimer's Disease Treatment Clinic will take about a week. Conditions that this drug treats are mild cognitive impairment and early Alzheimer's disease.
You may have one or more of these tests:
Alzheimer's drug treatment eligibility
Your health care team will answer any questions you have about your diagnosis or treatment plan.
Most people are referred to the team of specialists in the Alzheimer's Disease Treatment Clinic by a doctor or other member of their care team. Talk with them about whether your condition makes this treatment a good choice for you. Eligibility for this therapy depends on your condition and other factors.
Your clinic team will talk with you about the factors that might make you eligible to receive infusions in the clinic:
- Do you live within 100 miles of Mayo Clinic? If you live outside this area, then Mayo Clinic can still evaluate your eligibility for the treatment. But due to the need to monitor people using this medication, you would need to work with your health care team to receive your infusion and follow-up care at a medical facility closer to where you live.
- Can you commit to returning to the clinic every two weeks for an infusion therapy?
- Can you commit to having tests throughout the long-term course of treatment? These will include MRI scans.
- Can you bring a reliable care partner with you to each visit?
What to expect during your lecanemab infusion
An infusion session
Your health care team will answer any questions you have before you undergo an infusion of medication.
Once you are approved for Alzheimer's drug treatment, you can expect therapy to proceed as follows:
- First visit for drug therapy. You'll be scheduled for an infusion appointment after you have had any needed tests and your care team has decided that a new Alzheimer's infusion medication is an option for you. This medication is usually given every two weeks.
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Length of treatment. The treatments are given in a clinic, which means you don't need to be admitted to a hospital for an overnight stay. Plan to be on-site for up to two hours each time. You'll need to bring someone with you who is reliable and can attend all visits with you. Before your infusion starts, a needle is inserted into an arm vein. The medication flows for about 60 minutes. Soon after the needle is removed, you'll be able to leave the clinic.
You'll return every two weeks for another infusion, for as long as you and your doctor think it's a good treatment for you.
- Follow-up care. A member of your health care team will ask that you return for follow-up visits, which may include more blood tests and scans. These tests will help your health care team make sure the medication is working properly and to watch for unwanted effects.
Side effects of lecanemab (Leqembi)
Side effects from taking lecanemab (Leqembi) can occur, including:
- Mild to severe neurological symptoms.
- Brain swelling.
- Brain bleeding.
These side effects are known as amyloid-related imaging abnormalities, also known as ARIA. If you receive the medication, you'll need to have MRI scans of the brain to monitor for these side effects. You may not have symptoms from ARIA if they are found and cared for promptly.
Call your health care team right away if you have new neurological symptoms, including changes in vision, confusion, dizziness, headache, nausea or seizures. Symptoms from the brain swelling and microbleeding occurred in less than 5% of people treated with lecanemab in its clinical trial.
Potential serious side effects. Serious side effects can rarely occur from using lecanemab. These include:
- Seizure.
- Larger brain bleeds.
- Death.
In order to make the treatment as safe as possible, people with other significant active medical issues will not be eligible to receive this medication. Examples of such conditions are cancer, recent heart disease, lung and breathing issues, and kidney failure. Another group of people who are ineligible to use lecanemab are those who take medications that thin the blood, other than aspirin.
Research
Mayo Clinic's Alzheimer's Disease Research Center has long been involved in advancing the understanding of Alzheimer's disease and other neurodegenerative diseases.
Sept. 12, 2023