# What ED Physicians Need to Know About New Amyloid Targeting Treatments: Side Effects and Treatment Cautions Part 2

About This Podcast

In 2024, dementia care costs are projected at 360 billion dollars, anticipated to rise to 1 trillion by 2050. Currently, 7 million people in the US have Alzheimer’s Disease (AD). AD not only affects individuals but also their families, with 11 million unpaid family caregivers providing essential support for those living with AD. New Amyloid Targeting Treatments (ATTs) have the potential to offer some therapeutic benefits for AD. However, there are some side effects and risks associated with them, particularly the use of one of the more controversial drugs in Emergency Medicine, tPA.

In Part 2 of this series, Dr. Christina Shenvi, Dr. Richard Isaacson, and Dr. Kevin Biese continue their conversation on ATTs using case scenarios to illustrate the decision-making challenges faced by Emergency Department (ED) care providers. This episode highlights the nuanced and rapidly evolving landscape of treating Alzheimer’s patients with these new medications and what EDs need to consider as they prepare to care for these patients.

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https://youtu.be/K02Y3REFIqQ

For more on this topic, listen to Part 1.

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Key Points

Emergency department physicians face significant challenges managing patients on ATTs who present with stroke-like symptoms. The uncertainty is compounded by the lack of extensive data on the interaction between thrombolytics, such as tPA, and these treatments.

Shared-decision making is essential in ED settings to balance the risks and benefits of using thrombolytics, ideally involving the interdisciplinary team and the patient’s family.

Consider the patient’s vascular risk factors, duration of treatment with ATTs, and access to MRI.

Patients on ATTs may face a higher risk of intracranial hemorrhage when treated with tPA for stroke.

There is a need for proactive planning and a standardized approach to managing patients on ATTs.

There is a need for conversations between neurologists, social workers, and patients about conveying which patients are on ATTs to emergency medical providers.

ED physicians should stay updated with evolving guidelines and evidence to ensure they are making informed decisions.

Related Resources

TOOLKIT | March 28, 2024

Preparing your Emergency Department for Patients on Amyloid-Targeting Therapy

A toolkit capturing key information of amyloid-targeting therapy and offers practical guidance you can easily integrate into your everyday clinical practice.

Explore Toolkit

WEBINAR | March 25, 2024

A Guide to Amyloid-Related Imaging Abnormalities in Alzheimer’s Disease

This webinar focuses on emergency medicine clinicians’ role in the recognition and acute management of ARIA, including how ARIA may present and what courses of action are needed for different ARIA severities.

Watch Webinar

References

https://pubs.rsna.org/doi/10.1148/rg.230009

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10629981/

https://www.mdpi.com/2077-0383/13/5/1245

Next, listen to Why Hospital-at-Home May be the Best Option for Your Next Patient with Dr. Mike Craig.

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