Disease Modifying Therapy in Alzheimer’s Disease: Evidence, Safety, and Clinical Use N608

Course Summary

Alzheimer’s disease has historically been treated with therapies that provide limited symptomatic benefit without altering disease progression. Advances in the understanding of amyloid-β pathology have led to the development of monoclonal antibodies that represent the first disease-modifying treatments shown to slow clinical decline in selected patients with early symptomatic Alzheimer’s disease. This course reviews the diagnosis, staging, and natural progression of Alzheimer’s disease and examines the evidence supporting the approval of anti-amyloid monoclonal antibodies, including clinical trial outcomes, safety considerations, and differences in dosing strategies. Emphasis is placed on patient selection, biomarker confirmation, monitoring requirements, and management of amyloid-related imaging abnormalities (ARIA) to support informed, evidence-based use of these therapies in clinical practice.

Course Format

Homestudy

Course Syllabus

• Introduction
• Epidemiology and Disease Burden
• Pathophysiology and Therapeutic Targets
• Clinical Diagnosis and Staging
• Natural History, Prognosis, and Treatment Goals
• Guideline and Consensus Recommendations
• Pharmacologic Treatment Overview
  • Historical Symptomatic Therapies
  • Transition to Disease-Modifying Therapy
• Disease-Modifying Anti-Amyloid Monoclonal Antibodies
  • Donanemab-azbt (Kisunla®)
  • Lecanemab (Leqembi®)
• Comparative Considerations: Donanemab-azbt vs Lecanemab
• APOE Genotyping and Counseling
• ARIA Risk Stratification and Management
• Patient Selection and Clinical Implementation
• Treatment Duration and Discontinuation
• Case Study: ARIA-E/H Following Lecanemab
  • Background
  • Case Presentation
  • Discussion
• Summary

Authors

Richard Daniels, PharmD, BCPS

Richard “Cole” Daniels earned his Doctor of Pharmacy(PharmD) from the Skaggs School of Pharmacy at the University of Montana in 2018. Throughout pharmacy school he completed a 3-year internship at Community Medical Center in Missoula, Montana in which he gained valuable experience in an acute care setting. Cole currently serves as a psychiatric clinical staff pharmacist at the Montana State Hospital. He has over 11 years of pharmacy experience having worked in several settings including retail, acute care, and inpatient psychiatric care. Cole has a diverse set of interests. However, acute care medicine, infectious disease, pain management, and asthma/COPD are a primary focus of his at the Montana State Hospital. He obtained board certification as a certified pharmacotherapy specialist in the Spring of 2022.

Elisabeth Gordon, BScPharm, RPh

Elisabeth Gordon earned her BSc(Pharm) from the University of British Columbia in 2004. After graduation, she worked in community retail pharmacies on Vancouver Island, before returning to her rural hometown of Salmon Arm. In 2016 and 2017, Elisabeth trained with Pallium Canada and Victoria Hospice to enhance her knowledge of end-of-life-care and palliative services. She is a volunteer medical supervisor for T1DOutreach, a peer support platform for adults living with type 1 diabetes, and a member of a Canadian peer support group for adults living with Birdshot Uveitis. Elisabeth enjoys working in a small, fast-paced rural pharmacy where she brings compassion and empathy to her everyday practice.