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Review
. 2025 Dec;37(6):e70167.
doi: 10.1111/1742-6723.70167.

Monoclonal Antibody Therapies in Alzheimer's Disease: A Guide for Emergency Physicians

Scott Wrigley  1 , Andrew L H Huynh  1   2 , Sanka Amadoru  1   2   3   4 , Henry Zeimer  1   5 , Irene Tan  1   6   7 , Michael Woodward  1   2 , George Braitberg  8   9 , Paul Andrew Yates  1   2   5
Affiliations
Review

Monoclonal Antibody Therapies in Alzheimer's Disease: A Guide for Emergency Physicians

Scott Wrigley et al. Emerg Med Australas. 2025 Dec.

Abstract

Whilst the advent of novel disease-modifying medications for Alzheimer's disease represents potential benefit for patients and caregivers, they may be associated with adverse events that present important considerations for emergency and primary care. This article seeks to highlight some of the challenges Emergency Departments may encounter in relation to clinical presentations of people being treated with novel anti-amyloid monoclonal antibodies in the Australian context. Given the potential for harm if not recognised and managed appropriately, it is imperative that emergency clinicians are aware of possible treatment-related adverse events and have access to appropriate decision-making support and resources.

Keywords: Alzheimer's disease; amyloid‐related imaging abnormalities (ARIA); dementia; monoclonal antibodies; neurological deterioration.

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Conflict of interest statement

Associate Professor Paul Yates is currently a Principal Investigator in ongoing sponsored research assessing lecanemab and donanemab clinical safety and efficacy, with funding provided to his institution. He currently holds consultancy with Eisai and Lilly, the companies that manufacture lecanemab and donanemab respectively. Professor Michael Woodward has been a leading Australian researcher in Alzheimer's disease for many decades with contributions to several randomised clinical trials conducted by Lilly and Eisai, with funding provided to his institution. He currently provides expert opinion to and is a speaker for Lilly and Eisai. Professor George Braitberg is a Section Editor for Emergency Medicine Australasia. Dr Scott Wrigley has received consulting fees from Lilly, with all fees given to his medical institution. All other authors report no conflicts of interest.

Figures

FIGURE 1
FIGURE 1
Left hemispheric ARIA‐E on FLAIR imaging (3Tesla Magnetic Resonance Imaging) [31].
FIGURE 2
FIGURE 2
Multifocal haemorrhage following tissue plasminogen activator administration with background Lecanemab use [38].
See this image and copyright information in PMC

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