Literature Review: Anti-Amyloid Antibody Infusions in Alzheimer's Disease

At the heart of the current debate is a pressing question: Do anti-amyloid antibodies deliver meaningful clinical value for patients, or do they represent biological progress with limited real-world impact? Introduction The introduction of anti-amyloid antibodies such as Leqembi and Kisunla represents a new therapeutic option for early Alzheimer’s disease, offering only modest clinical benefit while introducing high cost and safety considerations. These newly approved agents provide limited clinical improvement at substantial financial and safety risk. The recent FDA approval of Leqembi and Kisunla marks a pivotal development in the therapeutic management of Alzheimer’s disease. Anti-amyloid antibodies are the first agents to demonstrate consistent large-scale biological effects on amyloid pathology in randomized controlled trials (Huang et al., 2023). Their introduction has generated both controversy and optimism. Consequently, clinicians must carefully weigh modest clinical benefits, economic implications, and safety concerns against the demonstrated biological effects. Appropriate patient selection is essential: eligible candidates typically have early symptomatic Alzheimer’s disease, confirmed by biomarker evidence of amyloid pathology, and no significant comorbidities that would increase the risk of adverse events. Patients must be able to tolerate regular MRI scans and intravenous infusions, and should not have medical contraindications such as a history of severe hypersensitivity to monoclonal antibodies or recent intracerebral hemorrhage. APOE ε4 carrier status, history of anticoagulant use, and the presence of microhemorrhages on MRI should also be considered when identifying suitable patients for these therapies.