Interpretation of an experience-based protocol for sequential-like therapy with anti-amyloid-β monoclonal antibodies

Shu Jun; Wei Wenshi

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Interpretation of an experience-based protocol for sequential-like therapy with anti-amyloid-β monoclonal antibodies

更新时间：2026-10-27

- Interpretation of an experience-based protocol for sequential-like therapy with anti-amyloid-β monoclonal antibodies
- Journal of Chongqing Medical University Pages: 1-6(2026)
- 作者机构：
  
  复旦大学附属华东医院神经内科/老年认知障碍中心，上海 200040
- 作者简介：
- 基金信息：
- DOI：
  CLC： R74
- Received：09 August 2026，
  
  Revised：2026-09-20，
  
  Accepted：10 October 2026，
  
  Published：27 October 2026
- 稿件说明：
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Shu Jun,Wei Wenshi.Interpretation of an experience-based protocol for sequential-like therapy with anti-amyloid-β monoclonal antibodies[J].Journal of Chongqing Medical University,
DOI：

Shu Jun,Wei Wenshi.Interpretation of an experience-based protocol for sequential-like therapy with anti-amyloid-β monoclonal antibodies[J].Journal of Chongqing Medical University, DOI：10.13406/j.cnki.cyxb..

摘要

随着仑卡奈单抗、多奈单抗相继在中国获批上市，首批接受治疗的阿尔茨海默病（Alzheimer’s disease，AD）患者已陆续完成既定治疗周期或停药标准。但现有国内外应用建议均以用药前筛查、用药期间监测为重心，治疗完成后的分层管理、动态监测及药物转换尚缺乏系统化的可操作框架。仁济认知中心于2026年发布了经验性指导方案，对这一环节进行了系统化完善：以淀粉样蛋白正电子发射断层显像（positron emission tomography，PET）定量测定Centiloid值为客观依据，建立“清除状态×清除速率”双轴分层管理框架，指导个体化维持剂量调整；提出停药后“血浆磷酸化 tau 蛋白217初筛+淀粉样蛋白PET确认”的两步动态监测法，并基于药物半衰期提出可操作的药物转换间隔建议。该方案形成了“从准入到退出”的完整管理闭环，为国内抗Aβ单抗治疗临床实践及后续共识制定提供了有益参考。

Abstract

With the successive approval and launch of lecanemab and donanemab in China，the first cohort of patients with Alzheimer’s disease who received these anti-amyloid-β monoclonal antibodies have gradually completed their predefined treatment courses or met the criteria for treatment discontinuation. However，existing domestic and international appropriate-use recommendations focus primarily on pretreatment screening and monitoring during treatment，while a systematic and practical framework for post-treatment stratified management，dynamic monitoring，and switching between antibodies remains lacking. In 2026，the Renji Cognitive Center published an experience-based protocol that systematically addresses this gap. Using quantitative Centiloid values obtained from amyloid positron emission tomography as an objective basis，the protocol establishes a two-axis stratified management framework based on amyloid clearance status and clearance rate to guide individualized adjustments to maintenance dose. It also proposes a two-step dynamic monitoring strategy after treatment discontinuation，consisting of initial screening with plasma phosphorylated tau 217 followed by confirmatory amyloid positron emission tomography，and provides practical recommendations for the interval for switching between antibodies based on their pharmacokinetic half-lives. Together，these measures establish a complete management pathway from treatment initiation to discontinuation，providing a valuable reference for the clinical practice of anti-amyloid-β monoclonal antibody therapy and for future consensus development in China.

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references

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