Experience with donanemab over a 1‐year period: observations of side effects and compliance from a regional specialty medical center
Lisa B. E. Shields, Hannah S. Hust, Gregory E. Cooper, Theresa Kluthe, Rachel N. Hart, Andrew P. Thaliath, Brandon C. Dennis, Stephanie W. Freeman, Jessica F. Cain, Whoy Y. Shang, Kendall M. Wasz, Adam T. Orr, Christopher B. Shields, Shirish S. Barve, Kenneth G. PughAbstract
INTRODUCTION
The anti‐amyloid monoclonal antibody donanemab (Kisunla™) treats patients with mild cognitive impairment or mild Alzheimer's disease.
METHODS
This study highlights 51 patients who received at least one donanemab infusion at our memory center between October 4, 2024 and October 3, 2025.
RESULTS
Of the 48 patients who underwent at least one surveillance brain MRI after starting donanemab, 10 (20.8%) had ARIA detected. ε4 carriers more frequently displayed amyloid‐related imaging abnormalities (ARIA‐cortical superficial hemosiderosis/microhemorrhages [ARIA‐H] and/or ARIA‐edema/effusion) ( p = 0.033) and ARIA‐H ( p = 0.020) compared to ε4 non‐carriers. No patients developed symptomatic ARIA. Seven (13.7%) patients experienced infusion‐related side effects. Eight (15.7%) patients discontinued donanemab due to ARIA progression (5), severe infusion reactions (2), and need for anticoagulants (1).
DISCUSSION
Donanemab may be safely used in a real‐world setting with structured monitoring. ARIA was observed in 20.8% of patients in this implementation cohort. Larger‐scale multicenter data are needed to benchmark rates.