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Anti-Amyloid Therapy Status — RACP Adult Medicine MCQ

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ModerateGeriatric MedicineAnti-Amyloid Therapy StatusRACP Adult Medicine

A 72-year-old man with moderate-to-severe Alzheimer's disease on donepezil 10 mg and memantine becomes increasingly dependent in ADLs. His family asks about the anti-amyloid monoclonal antibody lecanemab. What is the current status of anti-amyloid therapies in Australia?

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Correct answer: E — Not yet TGA-approved in Australia

As of early 2026, lecanemab and donanemab (anti-amyloid monoclonal antibodies that showed modest cognitive benefit in early AD in the CLARITY AD and TRAILBLAZER-ALZ 2 trials) have received regulatory consideration but are NOT yet widely approved and PBS-listed in Australia. Their use is restricted to early symptomatic AD (MCI or mild dementia) with PET or CSF confirmed amyloid pathology. Side effects include amyloid-related imaging abnormalities (ARIA – brain oedema and microhaemorrhages), requiring regular MRI monitoring.

Reference: TGA – 2025 – Anti-Amyloid Antibody Status; eTG – 2025 – Neurology