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Aduhelm

aducanumab
Used for Alzheimer's Disease

Aduhelm (aducanumab or aducanumab-avwa) is an anti-amyloid monoclonal antibody. It's used to treat mild Alzheimer’s disease in adults. Aduhelm (aducanumab) is given as a monthly infusion through the veins by a healthcare professional (HCP). Some side effects of this medication include headaches and confusion. Aduhelm (aducanumab) received FDA approval in 2021 under the accelerated approval process. But in 2024, the manufacturer of Aduhelm (aducanumab) announced that they plan to discontinue Aduhelm (aducanumab) in the United States.

Reviewed by:Last reviewed on April 24, 2024
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What is Aduhelm (aducanumab)?

What is Aduhelm (aducanumab) used for?

How Aduhelm (aducanumab) works

Aduhelm (aducanumab) is anti-amyloid monoclonal antibody. It specifically targets a protein in the brain called beta-amyloid. In Alzheimer’s disease, these proteins clump together to form plaques.

Aduhelm (aducanumab) lowers the amount of beta-amyloid plaques in the brain. This suggests, but doesn't show, Aduhelm (aducanumab) can help slow Alzheimer’s from getting worse. More studies are needed to confirm whether or not fewer plaques actually means slower disease progression.

Drug facts

Common BrandsAduhelm
Drug ClassAmyloid beta-directed antibody
Controlled Substance ClassificationNot a controlled medication
Generic StatusNo lower-cost generic available
AvailabilityPrescription only
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Side effects of Aduhelm (aducanumab)

The following side effects may get better over time as your body gets used to the medication. Let your healthcare provider know immediately if you continue to experience these symptoms or if they worsen over time.

Common Side Effects

  • Swelling in the brain (35%)
  • Headache (21%)
  • Small brain bleed (19%)
  • Deposits in the brain due to bleeding that can cause hearing loss or gait and balance issues (ARIA-H superficial siderosis, 15%)
  • Falling (15%)
  • Diarrhea (9%)
  • Confusion (8%)

Aduhelm (aducanumab) serious side effects

Contact your healthcare provider immediately if you experience any of the following.

  • Brain swelling or bleeding: headache, dizziness, nausea, confusion, or vision changes
  • Allergic reaction: hives (urticaria) or swelling of the lips, mouth, and throat

Source: DailyMed

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Pros and cons of Aduhelm (aducanumab)

Pros

  • Lowers the amount of amyloid beta plaques that build up in the brain
  • Given once every 4 weeks
  • Not many known interactions with other medications

Cons

  • Unclear if Aduhelm (aducanumab) can slow down Alzheimer's from getting worse
  • Given as an IV infusion by a healthcare professional
  • Requires MRIs (brain scans) before and during treatment
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Pharmacist tips for Aduhelm (aducanumab)

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  • A healthcare professional (HCP) will need to administer Aduhelm (aducanumab). Typically, you'll have to go into your prescriber's office or a clinic every 4 weeks for the infusion. If you can't make the appointment, call your HCP's office right away to reschedule or talk about next-steps.
  • Aduhelm (aducanumab) can cause amyloid-related imaging abnormalities (ARIA). These are common side effects that might not always cause symptoms, but can be serious. Call your HCP right away if you experience symptoms of ARIA, such as headaches, dizziness, nausea, confusion, or vision changes.
  • You'll need to get an MRI brain scan before starting Aduhelm (aducanumab) and before the 5th, 7th, 9th, and 12th dose. This is to check for swelling (ARIA-E) or bleeding (ARIA-H) in the brain.
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Risks and warnings for Aduhelm (aducanumab)

Aduhelm (aducanumab) can cause some serious health issues. This risk may be even higher for certain groups. If this worries you, talk to your doctor or pharmacist about other options.

Amyloid related imaging abnormalities (ARIA)

  • Risk factors: Being a carrier of the apolipoprotein E ε4 (ApoE ε4) gene

Aduhelm (aducanumab) can cause serious issues that show up on brain images (MRIs), though you might not feel symptoms. This includes brain swelling (ARIA-edema or ARIA-E) and brain bleeding (ARIA-hemosiderin deposition or ARIA-H). Before starting Aduhelm (aducanumab), you'll need a recent MRI from within the last year.

Brain swelling (ARIA-E) was more commonly seen in people who have the ApoE ε4 gene. Swelling was most likely to occur early in treatment within the first 8 doses. The majority of brain swelling cases went away after about 20 weeks.

In studies, about 10% of people who took Aduhelm (aducanumab) had symptoms due to ARIA. The most common symptoms are headache, confusion, dizziness, vision changes, and nausea. You'll likely need an MRI if you experience any of these symptoms. If you don't have symptoms, you'll still need MRIs before the 5th, 7th, 9th, and 12th dose as part of the regular monitoring needed while taking this medication. Depending on the severity of MRI scans, your prescriber might decide to temporarily pause, completely stop, or carefully continue your medication.

Allergic reactions

Aduhelm (aducanumab) can cause an allergic reaction in some people. You might get hives or feel your lips, mouth, and throat swell up which can make it difficult to breath. Let your healthcare team know right away so they can stop the infusion and give you the appropriate treatment.

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Aduhelm (aducanumab) dosage

Typical dosage for Aduhelm (aducanumab)

Aduhelm (aducanumab) is an intravenous (IV, into the veins) infusion that is administered by a healthcare professional (HCP) every 4 weeks. It takes about 1 hour to give the full dose of the medication. Doses are based on your body weight and your HCP will determine the appropriate dose for you each time.

The typical starting dose is 1 mg/kg. The dose is slowly raised over 6 months to the recommended maintenance dose of 10 mg/kg.

  • Doses 1 and 2: 1 mg/kg
  • Doses 3 and 4: 3 mg/kg
  • Doses 5 and 6: 6 mg/kg
  • Doses 7 and beyond: 10 mg/kg (maintenance dose)
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What are alternatives to Aduhelm (aducanumab)?

There are a number of medications that your doctor can prescribe in place of Aduhelm (aducanumab). Compare a few possible alternatives below.
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News about Aduhelm (aducanumab)

References

Best studies we found

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