2026 American Academy of Neurology Abstract Website

Jeffrey Gelblum¹, Bela Ajtai², Sarah Harlock³, Michael Hemphill⁴, Omotola Hope⁵, Cara Leahy⁶, Justin Moon⁷, Salvatore Napoli⁸, Jose Rocha⁹, Jose Soria Lopez¹⁰, David Weisman¹¹
¹First Choice Neurology, LLP, ²DENT Neurologic Institute, ³Dent Neurologic Institute, ⁴Savannah Neurological Specialists, ⁵Houston Methodist Sugarland Neurology Associates, ⁶Memorial Healthcare Institute for Neuroscience, ⁷Denver Neurological Clinic, ⁸Neurology and Infusion Centers of New England, ⁹First Choice Neurology, ¹⁰The Neuron Clinic, ¹¹Abington Neurological Associates

Objective:

To establish recommendations for implementation of anti-amyloid monoclonal antibodies (mAbs) for treatment of Alzheimer’s disease (AD) by private practice neurologists.

Background:

Approval of anti-amyloid mAbs has revolutionized the AD treatment landscape, but implementation of these therapies is challenged by a lack of established guidelines for treatment in private practice settings. Delphi consensus methodology has previously been used to develop clinical practice recommendations within the AD field.

Design/Methods:

A Delphi panel of 9 expert clinicians and administrators with experience implementing anti-amyloid mAbs for treatment of AD was convened to develop practice recommendations under the direction of 2 chairs. Initial insights from a panelist survey and working group meeting were used to develop preliminary recommendations, which were then vetted for clarity and importance by panelists.

Results:

Following completion of the Delphi process, panelists achieved consensus on 65 recommendations organized into 7 categories for which panelists faced the greatest challenges: addressing educational needs, patient identification, assessment and diagnosis, treatment, management and monitoring, administrative challenges, and other important statements. Key recommendations emphasized the importance of educating primary care physicians and other providers working with older adults to increase the urgency of identifying appropriate patients with early AD. Expert panelists recommended use of emerging blood-based biomarkers for triaging in primary care settings as well as for confirmatory diagnosis and determination of treatment eligibility, where appropriate. Consensus recommendations note that while continuation of treatment with anti-amyloid mAbs should follow prescribing information, updated guidance on maintenance treatment will be provided with continued experience and emerging clinical data.

Conclusions:

Overall, application of these recommendations is intended to expand treatment outreach and facilitate implementation of evidence-based quality standards within private practice settings, ultimately improving access to anti-amyloid mAbs for appropriate patients with AD.