Leqembi & Kisunla

Lecanemab (Leqembi) & Donanemab (Kisunla™) — Anti-Amyloid Antibodies

Lecanemab and donanemab are the first drugs proven to slow Alzheimer's disease progression — not just manage symptoms. Both are IV monoclonal antibodies that clear amyloid-beta plaques from the brain. Lecanemab (approved July 2023) targets toxic protofibrils; donanemab (approved July 2024) targets a modified form of amyloid unique to plaques. Both require confirmed amyloid pathology and APOE4 genetic testing before use. They represent a historic milestone: for the first time, treating the underlying disease rather than its downstream effects. The tradeoff is a significant safety burden — brain swelling and microbleeds occur in a meaningful fraction of patients, and the absolute cognitive benefit, while real, is modest at 18 months.

Last updated
2026-05-09

How to read this sphere

The percentage on each node is the confidence level that a particular benefit or side effect is actually real — higher means more high-quality studies back it up. Once confidence crosses ~80%, the effect is considered Pacified: generally accepted as true by the scientific community.

Position reflects confidence: nodes closer to the center have stronger evidence; nodes near the edge are still speculative. As more studies are published, nodes migrate inward — or disappear entirely if the evidence collapses.

These are new drugs — both approved 2023–2024. The pivotal trials ran for only 18 months, so this sphere reflects the earliest chapter of what will be a decades-long evidence story. The ARIA safety nodes are well-established; the cognitive benefit nodes will likely shift inward as longer-term data emerge. Watch this sphere change.

6
Benefits
8
Malefices
23
Sources
76%
Avg. Confidence
BENEFITSMALEFICESCore80–100%Inner Mantle60–80%Outer Mantle40–60%Crust10–40%Earlier Diagnosi… (C.L. 55%)Benefit Persists… (C.L. 62%)Tau Biomarker Re… (C.L. 70%)Functional Decli… (C.L. 75%)Cognitive Declin… (C.L. 88%)Amyloid Plaque C… (C.L. 92%)Modest Absolute … (C.L. 48%)High Cost & Acce… (C.L. 50%)Anticoagulant Da… (C.L. 78%)Fatal / Severe A… (C.L. 80%)Infusion Reactions (C.L. 88%)APOE4: Dramatica… (C.L. 92%)ARIA-E: Brain Ed… (C.L. 95%)ARIA-H: Microhem… (C.L. 95%)

All Sources

Phase III RCT6 sources
Meta-Analysis2 sources
Observational Study14 sources
Case Report1 source

Last updated: 2026-05-09 · Data compiled from PubMed, ClinicalTrials.gov, FDA, and EMA databases.