Talking With Patients About the New Anti-amyloid Alzheimer Disease Medications
Catherine A. Sarkisian, Artem Romanov, John N. Mafi
Abstract
Ms. B is a 78-year-old patient presenting with mild memory loss.She says, "I don't want Alzheimer's.What about those new meds?Do they work?"The number of persons in the United States with Alzheimer disease will approach 14 million by 2060 (1)-a crushing statistic, especially in the absence of effective medical treatments.However, now we have new options: infusions of anti-amyloid- monoclonal antibodies (mAbs), which reduce the volume of amyloid plaques in the brain and slow disease progression for some patients with mild cognitive impairment and mild dementia.With the U.S. Food and Drug Administration's recent approval of aducanumab and lecanemab and the anticipated approval of donanemab, health systems are developing the infrastructure to provide mAbs amid active debate about who will provide this care.Meanwhile, patients, their families, and caregivers hear conflicting information: Some call mAbs game-changers, but others claim that high costs and frightening adverse effects offset potential gains.So, how should physicians answer patients like Ms.