Shared barriers keep Leqembi and Kisunla uptake challenging

The article’s central point is that Leqembi and Kisunla face many of the same adoption hurdles, so neither has an easy advantage with physicians—but those shared problems still make uptake difficult.

Doctors must identify eligible patients early and confirm Alzheimer’s disease with biomarker testing. Many practices lack the experience, staff, and referral pathways to do this at scale.

Both drugs require substantial monitoring for amyloid-related imaging abnormalities (ARIA), including brain swelling or bleeding. Safety concerns and the drugs’ relatively modest slowing of decline complicate risk–benefit discussions.

Treatment logistics are demanding:
patients need infusions, repeated MRI scans, and follow-up visits. Limited clinic capacity and uneven access to specialists and diagnostic infrastructure restrict who can receive treatment.

Physicians’ familiarity and comfort with these therapies are increasing, but education and experience alone will not resolve longer-term infrastructure and access constraints.

Later developments may ease some burdens:
Leqembi gained a weekly at-home maintenance injection option after its initial IV course, while Kisunla received a modified dosing schedule intended to reduce ARIA risk. These changes may help, but do not eliminate the underlying barriers.