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Anti-amyloid therapies and the transformation of Alzheimer's care pathways: early lessons from the frontline
Filippi M, Cecchetti G, Spinelli EG, Ghirelli A, Rugarli G, Pisano S, Canu E, Agosta F.. The Lancet regional health. Europe, 2026-02-12
Topic: Drug trials: efficacy and safety
The introduction of anti-amyloid monoclonal antibodies marks a major shift in Alzheimer's disease (AD) care, moving treatment toward biological modification and reshaping diagnostic and organizational models. At the Center for Alzheimer's and Related Diseases (CARD), IRCCS San Raffaele Hospital (Milan, Italy), among the first European tertiary centers to initiate both lecanemab and donanemab, we developed a structured fast-track pathway to support timely and safe access to therapy. Our early real-world experience highlights three critical domains. First, patient selection requires integration of cognitive, functional, and biological data, moving beyond rigid global score thresholds. Second, safety monitoring must balance ARIA risk with real-world feasibility through risk-adapted MRI surveillance. Third, effective implementation depends on transparent communication and continuous shared decision-making, particularly when benefit is uncertain or safety events occur. These elements underscore that the impact of disease-modifying therapies will depend not only on pharmacology, but on coordinated care models supported by real-world registries.
Key findings
- Our early real-world experience highlights three critical domains.
- First, patient selection requires integration of cognitive, functional, and biological data, moving beyond rigid global score thresholds.
- Second, safety monitoring must balance ARIA risk with real-world feasibility through risk-adapted MRI surveillance.
- Third, effective implementation depends on transparent communication and continuous shared decision-making, particularly when benefit is uncertain or safety events occur.
- These elements underscore that the impact of disease-modifying therapies will depend not only on pharmacology, but on coordinated care models supported by real-world registries.
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Study details
- Evidence strengthLow
How this study scored 47/100
Published in a peer-reviewed journal. Scored zero for study design, sample size, effect reported, studied in people and randomised / blinded because the record does not state it. We have no data on journal's citation record, times cited, citations per year, impact for its field and year, cited by studies here, still being cited, senior author's track record, institution's track record and multi-centre collaboration, so those were left out: it earned 27 of the 58 points we could judge it on, which is 47 out of 100.
| Component | Points | Why |
|---|---|---|
| Journal tier | 7 / 10 | Tier 3 — peer-reviewed journal (The Lancet regional health. Europe) |
| Journal's citation record | — / 4 | No journal record from OpenAlex — left out of this score |
| Study design | 0 / 12 | No study design recorded — scores zero, not guessed (not stated in the record — scored 0) |
| Strength of evidence | 1 / 5 | Rated “low” in our summary |
| Peer-review validation | 10 / 10 | Peer-reviewed. Published as an article in a named peer-reviewed journal. |
| How recent | 5 / 5 | 2026 — within 1 year(s) of the newest study here |
| Sample size | 0 / 4 | Participant count not stated — scores zero (not stated in the record — scored 0) |
| Effect reported | 0 / 3 | No effect size reported — scores zero (not stated in the record — scored 0) |
| Studied in people | 0 / 3 | Not stated whether this was studied in people — scores zero (not stated in the record — scored 0) |
| Randomised / blinded | 0 / 2 | No randomisation or blinding stated — scores zero (not stated in the record — scored 0) |
| Times cited | — / 7 | No citation count (not found in OpenAlex) — left out of this score |
| Citations per year | — / 5 | No citation count or no year — left out of this score |
| Impact for its field and year | — / 6 | No field-weighted citation impact (OpenAlex has none yet) — left out of this score |
| Cited by studies here | — / 6 | Not yet checked against this library's citation graph — left out of this score |
| Still being cited | — / 4 | No yearly citation counts — left out of this score |
| Senior author's track record | — / 4 | Senior author's record not available — left out of this score |
| Institution's track record | — / 3 | No institution listed in OpenAlex — left out of this score |
| Multi-centre collaboration | — / 3 | Institutions not listed — left out of this score |
| Indexed in PubMed | 2 / 2 | Indexed in PubMed (PMID 41732200) |
| Free to read | 2 / 2 | Free to read |
| Points | 27 / 58 | Scored on 11 of 20 parts. We have no data for the rest, so they are left out: 27 of the 58 points we could judge it on is 47 out of 100. |
| Total | 47 / 100 | — |
What each of these 20 components measures, and what this score is not →
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Cite this study APA, Vancouver, BibTeX · download .bib or .ris
Built from the record alzhub holds for this paper, not looked up. Volume, issue and page numbers are not held in the record. The record names 8 authors; APA and Vancouver show the first six, BibTeX and the downloads carry all of them. Check the citation against the original before you use it.
APA 7th
Filippi, M., Cecchetti, G., Spinelli, E. G., Ghirelli, A., Rugarli, G., Pisano, S., et al. (2026). Anti-amyloid therapies and the transformation of Alzheimer's care pathways: early lessons from the frontline. The Lancet regional health. Europe. https://doi.org/10.1016/j.lanepe.2026.101609
Vancouver
Filippi M, Cecchetti G, Spinelli EG, Ghirelli A, Rugarli G, Pisano S, et al. Anti-amyloid therapies and the transformation of Alzheimer's care pathways: early lessons from the frontline. The Lancet regional health. Europe. 2026. doi:10.1016/j.lanepe.2026.101609. PMID: 41732200.
BibTeX
@article{filippi2026-41732200,
author = {Filippi, M. and Cecchetti, G. and Spinelli, E. G. and Ghirelli, A. and Rugarli, G. and Pisano, S. and Canu, E. and Agosta, F.},
title = {{Anti-amyloid therapies and the transformation of Alzheimer's care pathways: early lessons from the frontline}},
journal = {The Lancet regional health. Europe},
year = {2026},
doi = {10.1016/j.lanepe.2026.101609},
pmid = {41732200},
url = {https://doi.org/10.1016/j.lanepe.2026.101609}
}