Observational studyAlzheimer's research & therapy2026
Real-world implementation of lecanemab and donanemab in an Italian memory center: a 1-year experience.
Observational study in Alzheimer's research & therapy, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.
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Who cites it
4 citing papers in PubMed.
- Anti-Amyloid Monoclonal Antibodies in Early Alzheimer Disease: Lecanemab and Donanemab.Neurology international · 2026Review
- Integrating frailty into decision-making for disease-modifying therapies in Alzheimer's disease: a proposed expert-opinion based approach.The journal of prevention of Alzheimer's disease · 2026Review
- The missing improvers: Tau pathology, neuroplasticity, and the case for tau-informed patient selection before amyloid immunotherapy.The journal of prevention of Alzheimer's disease · 2026Article
- From Target Engagement to Treatment Governance: The Evolving Role of Amyloid PET in Anti-Amyloid Therapy.The Lancet regional health. Europe · 2026Review
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Authors and funding
23 authors.
Funding
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Abstract
backgroundAnti-amyloid monoclonal antibodies are entering clinical practice for early symptomatic Alzheimer’s disease (AD), but European real-world data on feasibility, safety, and biomarker monitoring remain limited. We report the first year of implementation of lecanemab and donanemab in an Italian tertiary memory center.
methodsWe conducted a prospective observational real-world cohort study at the Center for Alzheimer’s and Related Diseases of IRCCS Ospedale San Raffaele (Milan, Italy). Twenty-nine treatment courses were administered in patients with early symptomatic AD (lecanemab, n = 9; donanemab, n = 20) under European Medicines Agency–aligned safety monitoring and risk-mitigation protocols. Given the unbalanced treatment groups, results are descriptive and not intended for direct comparison between treatments. Safety surveillance included serial magnetic resonance imaging for amyloid-related imaging abnormalities (ARIA) and systematic recording of infusion-related reactions. Biological monitoring included amyloid positron emission tomography with Centiloid quantification and plasma biomarkers (phosphorylated tau 181 and 217, glial fibrillary acidic protein, neurofilament light chain, and amyloid-β 42/40 ratio) at baseline and follow-up. Baseline comparisons and longitudinal changes were assessed using appropriate parametric or nonparametric statistical methods.
resultsARIA were infrequent. In donanemab-treated patients, mildly symptomatic ARIA-E occurred in 10% (2/20) and asymptomatic ARIA-H in 15% (3/20). In lecanemab-treated patients, asymptomatic ARIA-H occurred in 11% (1/9). Infusion-related reactions occurred in 21% (6/29) of treatment courses and were manageable with standardized premedication. Among 11 patients with six-month follow-up, amyloid burden decreased significantly (mean change − 52.4 Centiloids), and 75% of donanemab-treated patients (6/8) and 0% of lecanemab-treated patients reached amyloid positron emission tomography negativity (< 11CL). Plasma phosphorylated tau 181 and glial fibrillary acidic protein showed directional declines, consistent with expected biomarker trajectories under anti-amyloid therapy, while cognitive measures showed no significant change.
conclusionsIn a structured multidisciplinary framework, lecanemab and donanemab were feasibly implemented with a preliminary favorable early safety profile, substantial amyloid reduction, and measurable plasma biomarker changes in routine practice. This experience supports the feasibility of structured real-world pathways for deployment and monitoring of disease-modifying therapies in European memory clinics, within the limitations of a small cohort and short follow-up.
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