Anti-amyloid therapies, including lecanemab and donanemab, are Health Canada-approved treatments for people with mild cognitive impairment (MCI) or mild dementia due to Alzheimer’s disease. These medications are disease-modifying therapies (DMTs), meaning they work to slow the underlying changes in the brain associated with Alzheimer’s disease and may help delay worsening of symptoms over time.
These treatments are administered by intravenous (IV) infusion at regular intervals, with the specific schedule depending on the medication. Treatment duration and frequency may be adjusted based on individual response, monitoring results, and clinical recommendations. Therapy may be discontinued when treatment goals have been achieved or if it is no longer considered beneficial.
There are strict eligibility requirements for those who can receive anti-amyloid treatment. It is estimated that only around 10 per cent of patients assessed for cognitive impairment will meet criteria for the therapy. Your doctor will decide if you qualify based on your diagnosis, medical history, and test results (blood and imaging tests).
There are three core eligibility components for anti-amyloid treatment:
- Stage of disease: Patients must have mild cognitive impairment or mild dementia due to Alzheimer’s disease (i.e., early Alzheimer’s dementia).
- Genotype: Patients who carry two copies of the APOE ε4 gene cannot receive the medication due to a significantly higher risk of serious side effects, including amyloid-related imaging abnormalities (ARIA).
- Diagnostic confirmation: Amyloid pathology must be confirmed via PET or CSF testing, and patients must have a recent baseline MRI prior to treatment initiation.
Certain brain imaging findings, use of certain medications or serious medical comorbidities may disqualify patients from being eligible to receive the treatment.
It is important for patients to understand that anti-amyloid treatments have a risk of serious side effects known as amyloid-related imaging abnormalities (ARIA), which can include brain swelling and bleeding in the brain. Eligible patients require close medical monitoring, including regular MRI scans, to ensure safety throughout treatment.
Anti-amyloid treatments are given through intravenous infusion into a vein in the arm every two to four weeks.
Each infusion takes approximately one hour.
Infusions are closely monitored. Most side effects are mild and can easily be managed by a nurse. A doctor will intervene if a side effect is considered severe.
At this time, anti-amyloid treatments are only available through self-payment (out-of-pocket), as they are not currently available through publicly funded coverage or through private insurance carriers in Canada. This means that, for now, people who qualify for the medication must pay for it themselves.
In July 2026, Canada's Drug Agency (CDA-AMC) recommended public coverage of anti-amyloid medications. In Canada, it can take up to two years after regulatory approval for new medications to become publicly covered, while people with private or extended benefits often gain access much sooner.
The
Alzheimer Society of Canada urges faster, more coordinated reimbursement processes so that approval translates into timely, equitable access for all Canadians.
Patients of the Bruyère Health Memory Clinic who are eligible and interested will be referred to a patient support program that will link them to a community infusion centre to receive the treatment closer to home.
The Bruyère Health Memory Clinic is also working with partners across the region to create a referral stream to identify eligible and interested patients, supporting equitable access in our region.