Alzheimer’s disease is an irreversible, gradually progressive neurodegenerative brain disorder that frequently affects memory and thinking skills, and eventually, impairs the ability to carry out even simple tasks. While the specific causes of Alzheimer’s disease are not fully known, it is thought to be due to accumulation of amyloid plaques and formation of neurofibrillary tangles, that result in loss of neurons and their connections.
Aduhelm is the first new treatment approved for Alzheimer’s disease since 2003 and is the first therapy that targets the fundamental pathophysiology of the disease.
Amyloid plaques are a defining feature of Alzheimer's disease. These sticky clumps of protein form between the nerve cells in the brain and disrupt their function, eventually destroying them. One hypothesis among researchers is that if you can get rid of these toxic plaques, you can keep the brain cells from dying and curb cognitive decline. And that's exactly what aducanumab is designed to do.
The drug, a monoclonal antibody, proved in clinical trials to reduce amyloid plagues in the brain by sending a signal to the body's immune system to clear the plaques. It's still unclear, however, whether patients will see a benefit from their removal.
Aduhelm is given through a needle placed in the vein (intravenous (IV) infusion) in the arm that is given monthly for 12 months. Each infusion lasts about 1 hour.
The Northwest Neurology Memory Center physicians will determine a patient’s eligibility for aducanumab therapy. The criteria include:
This is consistent with the clinical trials performed on the therapy which led to FDA-approval. The research suggests that antibody therapies, like aducanumab, are more likely to help Alzheimer's patients earlier in the disease course, before irreversible brain damage is more widespread.
Before starting therapy, patients will be scheduled to meet with an Infusion Nurse to answer any additional questions you might have about Aduhelm, review and ensure baseline criteria has been met, and to perform a medication reconciliation. The Infusion Nurse will schedule your infusion therapy and MRI appointments. On the same day, patients will also meet with a Financial Counselor to determine benefits eligibility, patient assistance programs and any potential out-of-pocket costs.
Patients starting Aduhelm therapy must have had an MRI of the brain done within the past 12 months. If an MRI has not been performed, or was performed more than 12 months ago, the Infusion Nurse will schedule one for you at your earliest convenience.
Aduhelm is a monthly intravenous therapy for a total of 12 infusions. Each infusion lasts for 1 hour, followed by an additional hour of observation by the Infusion Nurse. Infusion appointments will be scheduled 21-28 days apart.
An MRI of the brain will be scheduled prior to the 7th and 12th infusion appointments. Depending on any possible side-effects or symptoms, your physician may order additional MRIs.
Like all drugs, aducanumab can come with side effects. Amyloid Related Imagining Abnormalities or “ARIA” is common side effect that usually does not cause any symptoms but can be serious. It is most commonly seen as temporary swelling in areas of the brain that usually resolves overtime. Some people may also have small spots of bleeding in or on the surface of the brain with the swelling. Although most people with swelling in areas of the brain do not have symptoms, some people may have symptoms such as: headache, dizziness, confusion, vision changes, nausea, or a fall.
Your physician will do MRI brain scans before and during your treatment to check for ARIA. If you have any of the symptoms listed above, you should call your healthcare provider or go to the nearest hospital emergency room.
Before each infusion, the Infusion Nurse will review a list of potential side-effects and symptoms with you and your care partner.
In addition, Aduhelm may cause serious allergic reaction. Swelling of face, lips, mouth, or tongue and hives have happened during an Aduhelm infusion. Each infusion will be followed by additional hour of observation by the Infusion Nurse to monitor for any allergic reaction.
The Northwest Neurology Memory Center is led by Dr. Malgorzata Bach, a neurologist specially experienced and trained in Dementia and Alzheimer’s Disease. Dr. Bach will provide the opportunity for interested patients to participate in research, an observational study (ICARE AD) that will evaluate long term clinical benefits of treatment with aducanumab. Dr. Andrea Dellaria is another Memory Center neurologist who is specially trained in behavioral neurology. Both of these physicians can determine if Aduhelm is right for you. Patients can schedule appointments with either Dr. Bach or Dr. Dellaria at our Lake Barrington, Libertyville, Elk Grove Village, or Chicago locations.
Aduhelm Therapy will be offered at all three Infusion Center locations – Lake Barrington, Libertyville and Rolling Meadows. Northwest Neurology’s infusion nurse team is specially trained in the delivery of Aduhelm, as well as in the recognition of potential symptoms and side-effects. The team has been trained to answer any questions you may have about infusion therapy.