Recommendations for sequential-like management of anti-amyloid-β monoclonal antibody therapy in Alzheimer's disease: An experience-based protocol from Renji Cognitive Center (2026)

GENG Jieli , ZHI Nan , SONG Yaying , CAO Wenwei , WANG Liling , XIAO Jinwen , LI Haixia , JI Chenhui , WANG Jintao , LI Jianping , LI Shuang , HU Yiying , MIN Shurui , ZHANG Bei , WANG Hualong , WANG Gang

Journal of Neurology and Neurorehabilitation ›› 0

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Journal of Neurology and Neurorehabilitation ›› 0 DOI: 10.12022/jnnr.2026-0156
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Recommendations for sequential-like management of anti-amyloid-β monoclonal antibody therapy in Alzheimer's disease: An experience-based protocol from Renji Cognitive Center (2026)

  • GENG Jieli1, 2 , ZHI Nan1, 2 , SONG Yaying1, 2 , CAO Wenwei1, 2 , WANG Liling1, 2 , XIAO Jinwen1, 2 , LI Haixia1, 2 , JI Chenhui1, 2 , WANG Jintao1, 2 , LI Jianping1, 2 , LI Shuang1 , HU Yiying1 , MIN Shurui1 , ZHANG Bei1 , WANG Hualong1 , WANG Gang1, 2
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Abstract

With the increasing clinical use of anti-amyloid-β (Aβ) monoclonal antibodies in Alzheimer's disease (AD) in China, some patients have completed or are approaching the predefined treatment period, leading to emerging clinical questions regarding post-treatment maintenance, discontinuation, monitoring, and retreatment. However, no consensus has yet been established on long-term management or sequential-like treatment strategies after anti-Aβ monoclonal antibody therapy. Based on current clinical evidence and the practical experience of the Cognitive Center of Renji Hospital, Shanghai Jiao Tong University School of Medicine, this article proposes an experience-based protocol for sequential-like management of anti-Aβ monoclonal antibody therapy. The protocol uses amyloid PET-derived Centiloid values as the core objective reference and recommends stratified management according to clinical clearance status and prior amyloid clearance rate. After treatment discontinuation, dynamic monitoring with plasma p-tau217 protein and amyloid PET is recommended, and an increase in the Centiloid value to >24.1 CL may serve as an important reference for restarting anti-Aβ monoclonal antibody therapy. This protocol is intended to provide a clinical reference and requires further validation and optimization through real-world studies and long-term follow-up.

Key words

Alzheimer’s disease / Amyloid- β / Monoclonal antibody / Sequential-like therapy / Lecanemab / Donanemab / Positron emission tomography

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GENG Jieli , ZHI Nan , SONG Yaying , CAO Wenwei , WANG Liling , XIAO Jinwen , LI Haixia , JI Chenhui , WANG Jintao , LI Jianping , LI Shuang , HU Yiying , MIN Shurui , ZHANG Bei , WANG Hualong , WANG Gang. Recommendations for sequential-like management of anti-amyloid-β monoclonal antibody therapy in Alzheimer's disease: An experience-based protocol from Renji Cognitive Center (2026)[J]. Journal of Neurology and Neurorehabilitation. 0 https://doi.org/10.12022/jnnr.2026-0156
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