New Delphi Consensus Guidance for the Use of Anti-Amyloid Therapies in Alzheimer Disease

A Delphi consensus panel has developed a set of practical recommendations to support the implementation of anti-amyloid monoclonal antibodies (mAbs) for Alzheimer disease (AD) treatment in private neurology practice. Recommendations from the panel were presented at the 2026 American Academy of Neurology (AAN) Annual Meeting. The new recommendations address key barriers to anti-amyloid therapy adoption, including patient identification, diagnostic workflows, and practice-level logistics, with the goal of improving access to newly approved disease-modifying therapies.

The panel consisted of 9 clinicians and administrators with experience implementing anti-amyloid mAbs who participated in a structured Delphi methodology process led by 2 panel chairs. Initial insights from surveys and working group discussions were used to draft recommendations, which were then refined and validated through iterative panel review to establish agreement on clarity and importance.

Panelists reached consensus on 65 recommendations across 7 domains: education, patient identification, assessment and diagnosis, treatment, management and monitoring, administrative considerations, and additional practice guidance.

Key Findings

• The recommendations emphasize the education of primary care clinicians and other frontline providers to improve early recognition and referral of patients with suspected early-stage AD.
• The panelists supported the use of emerging blood-based biomarkers for triaging patients in primary care settings and, where appropriate, for confirming diagnosis and determining treatment eligibility.
• The guidance highlights the need for structured workflows for treatment initiation, monitoring, and ongoing management, aligned with prescribing information.
• The panelists noted that recommendations for maintenance therapy will likely evolve as additional clinical data and real-world experience with anti-amyloid mAbs become available.

These consensus-based recommendations are intended to help standardize care delivery and address practical challenges in implementing anti-amyloid therapies, particularly in nonacademic settings, where infrastructure and experience may vary.

Source

Gelblum J. Delphi consensus for implementation of anti-amyloid mAbs in private practice neurology: recommendations from experienced providers. Presented at: American Academy of Neurology Annual Meeting; April 18-22, 2026; Chicago, IL.