Does anyone in your family, maybe your mother, father, or grandmother, forget little things? When you can't remember even the smallest things, we also feel very sad and scared. The main reason for this may be Alzheimer's disease. In fact, there is no cure for this disease yet. However, there are new treatments that can help control the rapid spread of the disease and slow its progression. Kisunla is one such drug that has brought new hope. Let's talk about this simply and clearly today.
Alzheimer's disease and how Kisunla works
Simply put, Alzheimer's is a brain disease that develops gradually over time. You may have heard of it as a memory loss disease that is common among older adults. When this disease develops, the parts of our brain that control important things like memory, understanding, language, attention, and reasoning are damaged. The main reason for this is the accumulation of a toxic protein called amyloid between brain cells.
Just like a water pipe in our house becomes clogged with dirt and stops the water flowing, when this amyloid protein accumulates between brain cells, the brain cells are unable to communicate with each other and function properly.
You may have heard that Alzheimer's disease is a type of dementia. Dementia is a general term for conditions that cause difficulty thinking clearly to the point where you can't perform everyday tasks.
Doctors usually divide the disease into several stages. In the early stages, short-term memory loss is the main symptom. As the disease progresses, even everyday tasks such as preparing food, finding your way, and managing money become difficult. In the later stages, you may also show psychological symptoms such as social withdrawal, loss of interest in anything, and agitation.
So, what does this new drug called Kisunla do? It contains a special antibody called donanemab-azbt . What it does is it targets the amyloid proteins that I mentioned earlier that accumulate in the brain and removes them from the brain. In this way, Kisunla helps to reduce brain damage and slow down the rate at which the disease worsens.
How to use Kisunla medicine?
Kisunla is not a pill. It is given as an intravenous (IV) infusion . Just like we would get saline, you will have to receive this treatment in a hospital or clinic, which takes about 30 minutes.
When you start treatment, you will be given three doses of 700 milligrams (700 mg) every four weeks. After that, your doctor will increase the dose to 1400 milligrams (1400 mg) every four weeks.
Before starting this treatment, your doctor will order a special brain scan called a tau positron emission tomography (PET) . This checks how much amyloid has been deposited in your brain. If the scan shows that the level of amyloid in your brain has decreased significantly, your doctor may decide to stop treatment.
Special points to watch out for and side effects
There is a serious side effect that we need to be especially careful about when treating Kisunla. It is called ARIA (amyloid-related imaging abnormalities) . Simply put, this drug causes abnormal changes to be seen on an MRI scan of the brain. This does not always cause symptoms.
However, rarely, some people may experience symptoms like these:
- Headache
- Confusion
- Vomiting
- Vision changes
- Loss of balance when walking
Sometimes the symptoms of ARIA can be very similar to those of a stroke. Therefore, it is extremely important to tell your doctor about all the medications you are taking so that he or she can determine whether it is due to ARIA or something else.
Who is at higher risk of ARIA?
Some people have a higher risk of developing ARIA depending on their genetic makeup. People with two copies of the gene called apolipoprotein E e4 (ApoE e4) are at higher risk of developing serious side effects such as brain swelling or bleeding in the brain. Therefore, your doctor will likely order a genetic test to check your risk of ARIA before you start treatment with Kisunla. You will also need to have regular MRI scans to monitor this condition during treatment.
How was the success of the Kisunla drug studied?
A large clinical study has been conducted to see how effective this drug is. A large number of patients with early-stage Alzheimer's disease have participated in this.
The researchers divided these people into two groups.
1. One group was given: Kisunla medicine.
2. The other group: was given something that looked like the medicine, but had no active ingredient (we call this a placebo ).
The results are really encouraging. Let's understand those results simply from the table below.
| Benefit | What the study found |
|---|---|
| Slowing the spread of the disease | The rate of disease progression in those who received Kisunla was about 20% slower than in those who received placebo. |
| Symptoms not getting worse | Forty-seven percent of those who received Kisunla had no worsening of their disease within a year, compared with only 29% of those in the placebo group. |
| Decreased amyloid in the brain | At the end of the study, 76% of those who received Kisunla had very low levels of amyloid deposits in their brains. |
These results show that the Kisunla drug can significantly slow the progression of Alzheimer's disease.
How long does it take for the medicine to work and are there any interactions with other medications?
As soon as you receive your first dose of Kisunla, it starts working by targeting amyloid in the brain. However, it can take several months for you, your caregivers, and your doctor to notice that your symptoms are decreasing and the course of the disease is slowing down.
Interactions with other drugs
Because of the risk of brain bleeding with ARIA, special care should be taken when using Kisunla with blood thinners . Although there is no clear evidence yet, if you are taking blood thinners, you should definitely discuss this with your doctor before starting Kisunla treatment.
The most important thing is to inform your doctor about all the medications you are taking - whether prescribed by your doctor, over-the-counter medications, vitamins, Ayurvedic or Sinhala medicines.
If you experience any symptoms such as a headache during treatment, do not ignore it. It could be a sign of ARIA, so inform your doctor immediately .
Take-Home Message
- Kisunla is a new drug used to treat the early stages of Alzheimer's disease.
- This works by removing the toxic protein called amyloid that accumulates in the brain and slowing down the rate at which the disease worsens.
- This is an intravenous (IV) infusion treatment and must be received in a hospital or clinic.
- It is very important to be aware of the serious side effect called ARIA. This requires regular MRI scans before and during treatment.
- It is essential to talk openly with your doctor about all medications you are taking (including blood thinners) and any new symptoms you are experiencing.
- Although this is not a cure, it significantly slows the course of the disease and gives new hope to patients and their families.
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