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Donanemab: Difference between revisions

From Pharmacopedia
[pending revision][pending revision]
Expand Donanemab with Stahl-sourced detail (with skepticism)
Em-dash sweep: replace em-dash with comma per project rule; PendellsCorner verbatim quotes preserved.
Line 14: Line 14:
| pregnancy      = Limited data
| pregnancy      = Limited data
| legal          = Rx; ARIA monitoring required
| legal          = Rx; ARIA monitoring required
| intro          = '''Donanemab''' (brand name Kisunla) is a humanized monoclonal antibody targeting N-terminally truncated, pyroglutamated Aβ an Aβ form found predominantly in established plaques. FDA-approved in July 2024 for Alzheimer disease (MCI/mild AD). Unique among approved anti-amyloid mAbs: patients can '''discontinue treatment once amyloid PET shows plaque clearance''', typically within 12-18 months. This stop-criterion (a finite course rather than indefinite biweekly infusions like lecanemab) is donanemab's main clinical advantage.
| intro          = '''Donanemab''' (brand name Kisunla) is a humanized monoclonal antibody targeting N-terminally truncated, pyroglutamated Aβ, an Aβ form found predominantly in established plaques. FDA-approved in July 2024 for Alzheimer disease (MCI/mild AD). Unique among approved anti-amyloid mAbs: patients can '''discontinue treatment once amyloid PET shows plaque clearance''', typically within 12-18 months. This stop-criterion (a finite course rather than indefinite biweekly infusions like lecanemab) is donanemab's main clinical advantage.


Pivotal trial (TRAILBLAZER-ALZ 2): ~35% slowing of cognitive decline on integrated Alzheimer Disease Rating Scale (iADRS) over 18 months. The trial enriched for tau-positive patients. As with other anti-amyloid mAbs, ARIA is the principal safety concern, with higher rates than lecanemab (especially ARIA-E in ~25% of treated patients).
Pivotal trial (TRAILBLAZER-ALZ 2): ~35% slowing of cognitive decline on integrated Alzheimer Disease Rating Scale (iADRS) over 18 months. The trial enriched for tau-positive patients. As with other anti-amyloid mAbs, ARIA is the principal safety concern, with higher rates than lecanemab (especially ARIA-E in ~25% of treated patients).