Kisunla Clears Alzheimer's Plaques After 18 Infusions in Florida Patient

Q: While this breakthrough drug clears Alzheimer’s plaques, what hidden, potentially fatal brain risks are patients taking just to buy more time?

Patients taking Kisunla are accepting a known risk of ARIA — amyloid-related imaging abnormalities — which can mean brain swelling and brain bleeding, including microbleeds and, in rare cases, larger hemorrhages that can be fatal. That risk is serious enough that donanemab carries a boxed warning and requires MRI scans before treatment and during the early infusions, when ARIA is most likely to appear. Many cases are mild or asymptomatic, but some patients develop headache, confusion, dizziness, visual changes, seizures, or focal neurological symptoms that can resemble a stroke. Severe intracerebral hemorrhage has been reported with this class of anti-amyloid drugs. The danger is not equal for everyone. Risk is higher in people with APOE ε4, especially those who carry two copies of the gene, which is why genetic testing is recommended before treatment to help gauge safety. Patients with MRI signs of cerebral amyloid angiopathy, prior microbleeds, or other vascular vulnerability may also face greater risk. Kisunla’s benefit is that it can clear amyloid plaques and modestly slow decline in people with early symptomatic Alzheimer’s, as Scott Milinsky’s case illustrates. But experts stress that this is not a benign infusion therapy. It is a tightly monitored treatment that asks patients to weigh extra time and slower progression against the possibility of swelling, hemorrhage, seizures, and, in rare instances, death.

2 articles · Updated · CBS New York · Aug 7

A final PET scan showed Scott Milinsky's brain amyloid plaques were gone after 18 Kisunla infusions over 1.5 years at Broward Health North.
Kisunla, Eli Lilly's anti-amyloid drug, is used for early symptomatic Alzheimer's and aims to slow cognitive and functional decline by breaking up and removing plaque.
Dr. Hazel Wiley said the result is significant but not a cure because the treatment does not address tau tangles, another key feature of Alzheimer's disease.
Broward Health North is already treating more than 60 patients with Kisunla, underscoring growing use of a therapy Milinsky called a "game changer."