London Bridge Hospital
27 Tooley Street SE1 2PR London
Amyloid-targeting therapy
- Shown to slow the progression of Alzheimer's disease
- Two MHRA-approved therapies
- 99% of our neurology patients trust our care
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Amyloid-targeting therapy at HCA UK
Why choose us?
At HCA UK, you’ll be treated by renowned neurologists and neurosurgeons who are leaders in their field. From treating brain tumours with immunotherapy to stem-cell treatment for multiple sclerosis and fibre-mapping the brain, our approach is truly groundbreaking.
It means we’re one of the few hospital groups in the UK to offer amyloid-targeting therapies, giving you treatment options for Alzheimer’s disease. The most common form of dementia, Alzheimer’s disease accounts for 60% of dementia cases in the UK. Where existing treatments ease the symptoms of Alzheimer's, these innovative research-driven therapies delay the disease’s progression by up to a third in clinical trials over 18 months.
Amyloid-targeting therapies are a new type of treatment for Alzheimer’s disease that aim to slow its progression. These treatments involve the use of monoclonal antibodies, which help your immune system remove harmful proteins from the brain.
They work by targeting a protein called amyloid beta, which plays a key role in Alzheimer’s disease. By helping to clear amyloid beta, these therapies can slow down the progression of the disease.
Amyloid-targeting therapies do not cure Alzheimer’s. Rather than reversing symptoms or stopping the disease completely, they have been shown to slow the disease’s progression in people with mild cognitive impairment (MCI-AD) or early-stage Alzheimer’s dementia (mild AD). This means the condition will still get worse over time, but at a slower rate than if you did not have the treatment.
Currently, two amyloid-targeting therapies have been approved by the MHRA for treating mild Alzheimer’s or MCI-AD:
- Donanemab (brand name Kisunla )
- Lecanemab (brand name Leqembi)
If you’re considering amyloid-targeting therapy, we can help you understand whether it’s the right option for you.
Both donanemab and lecanemab have been tested in large clinical trials to understand their safety and efficacy in patients with early Alzheimer’s disease. After an 18-month treatment period, they slowed the rate of disease progression by up to nearly a third.
This means that over 18 months of treatment, these therapies may delay symptom progression by up to six months.
Amyloid-targeting therapies are designed for people in the early stages of Alzheimer’s disease. This stage is sometimes called "mild cognitive impairment" or "mild cognitive decline." If your Alzheimer’s disease has progressed to a moderate or later stage, these treatments won’t be effective and aren’t recommended.
Before starting treatment, you’ll need some tests to check if the therapy is right for you. These include:
- A test to measure your levels of amyloid beta, a protein linked to Alzheimer’s.
- A test to check your APOE gene status, which helps predict your response to treatment.
Amyloid-targeting therapies may not be suitable if you have uncontrolled medical, neurological, or mental health conditions. They’re also not recommended if you take blood thinners (anticoagulants).
Your consultant will talk to you about your options and help you understand if this treatment is right for you. If you have any questions, don’t hesitate to ask.
12,000
neurology consultations last year
33%
delays symptoms progression by up to a third in clinical trials
99%
of neurology patients say they can trust the care of our staff
Expert consultants
Specialising in Alzheimer’s treatment
State-of-the-art diagnostics
With results in as little as 48 hours
Pioneering care
We are one of the few hospital groups in the UK to offer amyloid-targeting therapy
The amyloid-targeting therapy process
What to expect
From the moment you step through the door until you’re ready to leave, we want you to feel as comfortable and reassured as possible.
One of the ways we can put you at ease is to let you know what to expect at each stage.
If you have any questions that aren’t answered here, or in the FAQ section below, please don’t hesitate to get in touch. Our team will be happy to help in any way they can.
01
Initial consultation
Before treatment, you’ll have an assessment with one of our specialist cognitive neurology consultants. They’ll be in touch with you as soon as possible after the assessment to discuss your suitability for treatment.
The tests you’ll have at your assessment may include the following:
- A cognitive test and neurological exam to check which stage of Alzheimer’s disease you’re in
- A brain MRI scan
- An amyloid PET scan to make sure you have high levels of amyloid beta
- A genetic test to see how many copies of a gene called APOE4 you have.
(Amyloid-targeting therapies aren’t suitable for people with two copies of this gene as they increase the risk of treatment complications such as brain swelling and bleeds.)
The decision to start amyloid-targeting therapy is significant, and we’re here to help – your safety and health are always our top priorities. Your consultant will outline the benefits and risks of the treatment, the safety and monitoring guidelines we have in place, and share any concerns they may have with you.
Whatever decision you make, we’re here to support you and your family.
02
Treatment
During treatment, amyloid-targeting therapy is administered via an intravenous (IV) infusion into a vein in your arm. Each infusion takes around an hour. How regularly you have the infusion depends on which treatment you choose:
If you have donanemab, you’ll have an infusion every four weeks.
If you have lecanemab, you’ll have an infusion every two weeks.
Both treatments are taken for up to 18 months. However, if you’re having donanemab, you might be able to finish treatment after 12 months if a PET scan shows the treatment has cleared sufficient amounts of amyloid from your brain.
You’ll have your infusions in one of our special infusion suites at London Bridge Hospital Private Care at Guy’s. Here you’ll be looked after by our expert medical and nursing staff, who’ll make sure your treatment is going well and that you’re safe and comfortable. After each infusion, you’ll have an observation period in case of any side effects and to ensure you’re safe. This observation period will be a little longer for your first few infusions as this is when side effects are more likely.
During the first nine months of your treatment, you’ll have regular clinical reviews with your neurologist every two months to check up on your progress. In the first 12 months of treatment, you’ll also have regular brain MRI scans to check for any swelling or bleeding in the brain.
03
Aftercare
Once you’ve finished your treatment, most of the amyloid beta plaques in your brain should have been cleared.
If you’re on donanemab, your treatment will take 18 months, and you won’t require any further maintenance treatment.
If you’re having treatment with lecanemab, you’ll switch to a maintenance treatment after your initial course has finished. The frequency of your infusion will be reduced from every two weeks to every four weeks – which is still enough to reduce the progression of your symptoms in the longer term. The risk of complications after this period is much lower, so you won’t need regular MRI scans, and you’ll have fewer clinical reviews. However, in order to make absolutely sure all’s well, we might still occasionally check for ARIA.
Where can I have my amyloid-targeting therapy?
Amyloid-targeting therapy is available at London Bridge Hospital. Our expert team will guide you through every step, from your initial consultation to treatment and ongoing care.
Private Care at Guy's
Great Maze Pond SE1 9RT London
Accessing private healthcare
Self-pay
Amyloid-targeting therapy treatments aren’t covered by health insurance, so you’ll need to pay for them yourself, as and when you need them.
And to give you peace of mind from the start, we’ll offer you a clear and transparent quote outlining exactly what’s included in your self-pay package.
Amyloid-targeting therapy FAQs
While quite straightforward, amyloid-targeting therapy will involve lots of visits to the hospital for infusions and scans. You’ll need to have someone you trust – a carer or loved one for example – to help get you to and from the hospital and support you in the event of any side effects.
They’ll need to be with you at all your hospital visits. It would help for them to have a good understanding of both the benefits and risks of the treatment, so they know what to expect.
Amyloid-targeting therapies have undergone rigorous clinical trials and are approved by regulatory bodies such as the MHRA for patients with mild cognitive impairment or early Alzheimer’s disease
As with many treatments, they are not risk-free. During the assessment process, your consultant will talk to you about these risks, and your suitability for amyloid-targeting therapy. Among the potential risks are:
Infusion-related reactions: These happen when your immune system has a reaction to the drug entering your veins, and can occur when a lot of drugs are given via infusion. These reactions may cause:
- Dizziness or light-headedness
- Fast heartbeat
- Fevers or chills
- Headaches
- Itching
- Nausea or vomiting
- Rashes
- Shortness of breath
The majority of infusion-related reactions are mild. Most people who experienced infusion-related reactions only did so during their first infusion. After this, they’re much less likely.
Amyloid-related imaging abnormalities (ARIA): Amyloid-targeting therapies can cause amyloid-related imaging abnormalities (ARIA). ARIA involve leakiness of the blood vessels in your brain leading to brain bleeding or swelling, or a combination of both.
As these are much more common in people with two copies of the APOE4 gene, the MHRA has disallowed the use of amyloid-targeting therapies in this group of people in the UK. We’ll carry out a genetic test to make sure you have one or no copies of the gene before starting treatment.
The rates of ARIA vary according to the amyloid-targeting therapy you are on:
Donanemab
1 in 3 people will develop a mild, asymptomatic ARIA
Around 3 in 50 people will develop symptoms
Fewer than 1 in 50 people will have serious complications from treatment
Lecanemab
Fewer than 1 in 5 people will develop a mild, asymptomatic ARIA
Fewer than 1 in 50 people will develop symptoms
Fewer than 1 in 100 people will have serious complications from treatment
It’s important to remember that, in the majority of cases, ARIA are very mild and don’t cause any symptoms – the ARIA are only detected during a regular MRI scan. A small group of people receiving amyloid-targeting therapy develop mild symptoms that might require additional MRI scans. Only very rarely does the treatment cause serious complications.
Reactions with other medications: As amyloid-targeting therapies can increase the risk of brain bleeding and swelling, you shouldn’t have these treatments if you’re taking strong blood thinners (anti-coagulants) to prevent blood clots. This also means that you won’t be able to take some stroke treatments (clot-busters) if you have a stroke whilst taking an amyloid-targeting therapy.
“It is a tremendous milestone in the treatment of Alzheimer’s Disease for us to now be able to offer treatments that help to delay clinical progression for patients still at the early stages of the condition.”
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This content is intended for general information only and does not replace the need for personal advice from a qualified health professional.