Italian intersocietal recommendations for restructuring the diagnostic-therapeutic pathway for the implementation and appropriate use of anti-amyloid monoclonal antibodies in Alzheimer’s disease
This joint Position Paper, developed by the Italian Expert Panel on Alzheimer convened by the Italian Society of Neurology with participation from multiple scientific societies, outlines strategic guidelines for reorganizing the patient journey in the era of anti-amyloid monoclonal antibodies for Alzheimer's disease. Emphasizing a multidisciplinary and integrated approach, the document recommends a patient journey that begins with early identification of cognitive impairment by General Practitioners, continues with specialized assessments at Memory and Dementia Centres, and leads, in carefully selected cases, to initiation of anti-amyloid monoclonal antibody therapy. It advocates the rational use of diagnostic tools, including plasma and cerebrospinal fluid biomarkers, advanced neuroimaging (MRI and PET), and genetic profiling (ApoE genotyping), not only to identify eligible patients but also to stratify those requiring alternative care strategies. The paper further defines minimum requirements for the accreditation of prescribing and infusion centres, highlighting the clinical competencies, structural resources, and inter-professional communication protocols necessary to ensure safety and appropriateness. Recognizing both the therapeutic potential and the organizational challenges associated with anti-amyloid monoclonal antibodies, the document aims to guide healthcare policymakers, institutions, and practitioners toward a coordinated reorganization of the diagnostic-therapeutic pathway, ensuring the safe and effective use of these treatments and ultimately improving outcomes and quality of care for individuals with Alzheimer's disease.
Authors
- Leonardo Pantoni (ORCID: https://orcid.org/0000-0001-7357-8530)
- Alessandro Tessitore (ORCID: https://orcid.org/0000-0003-1740-8566)
- Elena Marcello (ORCID: https://orcid.org/0000-0003-0452-762X)
- Walter Marrocco
- Sandro Sorbi (ORCID: https://orcid.org/0000-0002-0380-6670)
- Mirco Cosottini (ORCID: https://orcid.org/0000-0001-9400-6574)
- Giuseppe Bruno (ORCID: https://orcid.org/0000-0001-6948-7169)
- Enrico Mossello (ORCID: https://orcid.org/0000-0002-7730-5836)
- Sonia Francesca Calloni (ORCID: https://orcid.org/0000-0002-6899-422X)
- Raffaele Lodi (ORCID: https://orcid.org/0000-0003-3878-304X)
- Lucilla Parnetti (ORCID: https://orcid.org/0000-0001-5722-3967)
- Federica Agosta (ORCID: https://orcid.org/0000-0003-3121-4979)
- Giuseppe Bellelli (ORCID: https://orcid.org/0000-0001-5430-0947)
- Alba Rosa Alfano (ORCID: https://orcid.org/0009-0002-3510-8858)
- María Infantino (ORCID: https://orcid.org/0000-0002-6200-4467)
- Diego Cecchin (ORCID: https://orcid.org/0000-0001-7956-1924)
- Ovidio Brignoli
- Giancarlo Logroscino (ORCID: https://orcid.org/0000-0003-0423-3242)
- Laura Bonanni (ORCID: https://orcid.org/0000-0001-7443-9233)
- Camillo Marra (ORCID: https://orcid.org/0000-0003-3994-4044)
- Alberto Benussi (ORCID: https://orcid.org/0000-0002-8703-6940)
- Lorenzo Palleschi (ORCID: https://orcid.org/0000-0002-8056-0547)
- Andrea Falini (ORCID: https://orcid.org/0000-0002-1461-8755)
- Gabriella Bottini (ORCID: https://orcid.org/0000-0003-4683-6420)
- Marcello Ciaccio (ORCID: https://orcid.org/0000-0001-6120-9041)
- Andrea Ungar (ORCID: https://orcid.org/0000-0002-8965-4523)
- Sirio Cocozza (ORCID: https://orcid.org/0000-0002-0300-5160)
- Fabio Gotta
- Marco Bozzali (ORCID: https://orcid.org/0000-0002-0568-2026)
- Lorenzo Gaetani (ORCID: https://orcid.org/0000-0003-3967-8954)
- Antonio Antico (ORCID: https://orcid.org/0000-0003-0912-9751)
- Alessandro Padovani
- Patrizia Mecocci
- Diego De Leo
- Annachiara Cagnin
Institutions
- Università Cattolica del Sacro Cuore (IT)
- University of Pisa (IT)
- Griffith University (AU)
- University of Primorska (SI)
- University of Padua (IT)
- University of Trieste (IT)
- Vita-Salute San Raffaele University (IT)
- University of Milan (IT)
- University of Campania "Luigi Vanvitelli" (IT)
- University of Pavia (IT)
- University of Perugia (IT)
- Azienda Ospedaliera San Giovanni Addolorata (IT)
- Agostino Gemelli University Polyclinic (IT)
- Karolinska Institutet (SE)
- University of Chieti-Pescara (IT)
- Azienda Ospedaliera Citta' della Salute e della Scienza di Torino (IT)
- Luigi Sacco Hospital (IT)
- Azienda Socio Sanitaria Territoriale Grande Ospedale Metropolitano Niguarda (IT)
- Ospedale di Cattinara (IT)
- Azienda Socio Sanitaria Territoriale degli Spedali Civili di Brescia (IT)
- Azienda Ospedaliera San Gerardo (IT)
- Gruppo Italiano per lo Studio dei Carcinomi dell’Apparato Digerente (IT)
- Azienda Ospedaliero-Universitaria Careggi (IT)
- Casa di Cura Columbus (IT)
- Don Carlo Gnocchi Foundation (IT)
- Federico II University Hospital (IT)
- Istituto delle Scienze Neurologiche di Bologna (IT)
- IRCCS Ospedale San Raffaele (IT)
- Società Italiana di Medicina Generale (IT)
- Ca' Foncello Hospital (IT)
- Ospedale Policlinico San Martino (IT)
- Istituti di Ricovero e Cura a Carattere Scientifico (IT)
- Azienda Usl Toscana Centro (IT)
- Azienda Sanitaria Universitaria Integrata di Trieste (IT)
- Azienda Ospedaliera Universitaria Pisana (IT)
- Istituto di Ricovero e Cura a Carattere Scientifico San Raffaele (IT)
- University of Florence (IT)
- University of Turin (IT)
- University of Bari Aldo Moro (IT)
- University of Milano-Bicocca (IT)
- University of Brescia (IT)
- University of Genoa (IT)
- Sapienza University of Rome (IT)
- University of Palermo (IT)
- University of Bologna (IT)
Publication Details
- Journal
- Neurological Sciences
- Published
- 2025-10-17
- DOI
- https://doi.org/10.1007/s10072-025-08576-y
- Citations
- 6
- Primary Topic
- Dementia and Cognitive Impairment Research
- Type
- article
- Field-Weighted Citation Impact
- 8.83
Funders
- Alzheimer's Association