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Aducanumab: Appropriate Use Recommendations.

J Cummings1, P Aisen, L G Apostolova

  • 1Jeffrey Cummings, MD, ScD, 1380 Opal Valley Street, Henderson, NV 89052, jcummings@cnsinnovations.com, T: 702-902-3939.

The Journal of Prevention of Alzheimer'S Disease
|September 29, 2021
PubMed
Summary
This summary is machine-generated.

Aducanumab, an amyloid-targeting therapy for Alzheimer's disease (AD), should be used in early AD patients with confirmed brain amyloid. Recommendations focus on maximizing dose, monitoring for ARIA, and patient-centered decision-making.

Keywords:
ARIAAduhelm™Alzheimer’s diseaseMRIaducanumabamyloid imagingappropriate usetitration

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Area of Science:

  • Neurology
  • Pharmacology
  • Biotechnology

Background:

  • Aducanumab is an FDA-approved amyloid-targeting monoclonal antibody for Alzheimer's disease (AD).
  • Clinicians need guidance for appropriate use of this novel AD therapy.
  • An Expert Panel convened to establish Appropriate Use Recommendations.

Purpose of the Study:

  • To provide guidance on the appropriate use of aducanumab for Alzheimer's disease.
  • To define the patient population and treatment parameters for aducanumab therapy.
  • To outline safety monitoring and informed decision-making processes for aducanumab.

Main Methods:

  • Recommendations based on pivotal trial data, Prescribing Information, and expert consensus.
  • Defined target population: early AD with confirmed brain amyloid.
  • Established dosing titration, ARIA management, and MRI monitoring protocols.

Main Results:

  • Recommends aducanumab use restricted to early AD patients with confirmed amyloid.
  • Suggests titration to the highest dose (10 mg/kg) over 6 months for maximal efficacy.
  • Outlines management of amyloid-related imaging abnormalities (ARIA), including MRI monitoring and dose adjustments.

Conclusions:

  • Aducanumab use should be limited to the studied population (early AD with amyloid confirmation).
  • Titration to the maximum dose is recommended, with careful monitoring for ARIA.
  • Patient-centered informed decision-making is crucial, addressing therapy requirements, outcomes, risks, and uncertainties.