Risks of Anti-amyloid Antibody (IV) Infusion Therapy With Extreme Exercise?

Janey63

I am trying to find some answers on the risks of taking an anti-amyloid antibody (IV) infusion therapy while being physically active. My 63 yo husband (stage 4, APOE3/4) was just diagnosed with Alzheimers and he is a candidate for Kinsula or Lequmbi but we are worried about the risk of ARIA. He wants to keep mountain biking, hiking and skiing with us as long as possible. And most importantly be around as long as possible for our young adult daughters. His neurologist couldn't give us any insight on what extreme exertion would do (raising your BP and also be at 6-9,000 ft of altitude. We live at sea level in SF Bay Area) if he were to be on infusion therapy so now I'm crawling around the internet trying to see what I can find!

LBC83

I'm 64, APOE 3/4, I just had my 38th Leqembi infusion (I started in June 2024). I run 4 miles on a treadmill around 3 days a week, and on weekends I have a long run of around 8 miles. A week ago last Saturday I ran 12 miles.

I love the story of Ralph Carmona. He was diagnosed with AD about a decade ago, and started in an early clinical trial with Leqembi. In the Spring of 2025 he ran in the Boston Maraton, finishing in 4H14M42S (after suffering a cramp in his right calf). He had a negative split time (meaning he ran the 2nd half faster than the 1st half, which is very unusual). He is quoted a saying he intends to run again in 2026, at age 75. Another guy I know with AD on an anti-amyloid medication recently completed in an Iron Man competition.

I don't worry about "extreme exertion" & Leqembi (or if I was taking Kisunla). I enjoy life! I've been hiking, biking, kayaking, swimming laps, and other activities since being on Leqembi. I travel (flying in airplanes at high altitudes).

https://www.wmtw.com/article/more-than-a-marathon-portland-mans-race-against-alzheimers/64443875

lfaust58

Hi ... I applaud both you for your advocacy and your husband for his degree of exercise. I'm on Lequimbi, but have no idea of the effects of extreme exercise combined with it . My first guess if who might know would be your husband's doctor. I would then look to Esai or Lilly, the companies that provide those medications

lfaust58

The only information I've found that might be helpful.(although it doesn't address the exact question) is: https://www.brightfocus.org/resource/the-best-exercise-for-people-with-alzheimers-disease/#:~:text=8%20The%20exercises%20included%20walking,risk%20for%20developing%20Alzheimer's%20disease.

LBC83

Below is a clickable link to the article referenced by lfaust58, which seemingly mostly references a publication titled "Physical Activity Guidelines for Americans: 2nd Edition" published in 2018 by the U.S. Department of Health & Human Services. The guidelines recommend a minimum of 150 minutes of aerobic exercise per week.

https://www.brightfocus.org/resource/the-best-exercise-for-people-with-alzheimers-disease/

jaycey

I'm 65, on Kisunla, and I lift weights 3 times/week, use the ski machine at the gym for intens cardio, and fast-walk for 40 minutes per day. I've never heard of any negative interactions between exercise and these infusions. On the contrary, all of the medical journal articles I've read confirm that cardio exercise is recommended to keep blood flowing through the brain and "washing" the Amyloid plaques.

As far as the pressure modulations of flight, I have to fly 8 hours once per month to get my Kisunla (don't ask) and I've had no negative impact from that (no ARIA so far - knock on wood). I also was worried about flying, but neither I nor my neurologist could find anything about it, and when I called Lilly to ask, they couldn't find anything either, so I just wait a minimum of 24 hours before flying.

Janey63

https://alzconnected.org/discussion/comment/259157#Comment_259157

https://alzconnected.org/discussion/comment/259157#Comment_259157

Thank you so much LBC83 for your detailed information and others that have chimed in. We are feeling much better about having DH's start either Kisunla or Leqembi. Also, Ralph Carmona's story is so impressive! His neurologist was not helpful with the exercise or altitude question.

Janey63

Thank you Jaycey for sharing your situation too. I did have concerns about flying for DH too (to visit family and take bucket list trips) in addition to the exercise so glad to know that such long flights have been okay for you (wow, 8 hours?!).

Janey63

DH's neurologist would not weigh in on this (it was not factored in with the clinical trials testing etc). I did talk to Eli Lily's drug info support person and they dug around but did not find anything for Kisunla about extreme exercise or altitude. Will try that for Leqembi tomorrow. Thx.