Kisunla – a crucial decision is drawing near for people with Alzheimer’s in Sweden

Sweden’s New Therapies Council (NT-rådet) is expected to decide in the coming months whether Kisunla should be recommended for use in Swedish healthcare.

After this spring’s no to Leqembi, the question is a charged one. Kisunla can slow the disease – but how much is that worth?

What the research shows

Kisunla (donanemab) is an antibody that helps the body remove amyloid from the brain. In the large TRAILBLAZER-ALZ 2 trial, patients with early Alzheimer’s declined around 35 per cent more slowly over 18 months, in the group with low or intermediate levels of tau. Across the whole study population, the effect was around 22 per cent. The patients did not get better – but they got worse more slowly.

Kisunla is given every four weeks, and treatment can often be stopped once the amyloid has decreased. That means fewer hospital visits than with Leqembi.

The risks

The treatment can cause swelling and bleeding in the brain (ARIA). Careful patient selection, genetic testing and regular MRI scans are therefore required. It is only suitable for people with early Alzheimer’s.

TLV and the cost

TLV, the Swedish Dental and Pharmaceutical Benefits Agency, has estimated the cost at roughly SEK 1.6–4.5 million per quality-adjusted life year gained. For Leqembi, the figure was SEK 3.7–4.3 million. The uncertainty is considerable, especially regarding how long the effect lasts.