多奈单抗治疗阿尔茨海默病的真实世界应用:1例达到基于PET停药阈值的病例报告OA

Objective:To report the first real-world case of an Alzheimer's disease patient who achieved PET-defined amyloid clearance sufficient to meet the discontinuation criteria and successfully discontinue donanemab therapy,and to illustrate the feasibility of PET-guided individualized treatment duration in clinical practice. Methods:A 78-year-old female patient with AD was systematically evaluated before and after donanemab therapy.Cognitive function,amyloid-β(Aβ)and Tau PET imaging,and MRI findings were longitudinally monitored,along with the assessment of treatment-related adverse events. Results:After six infusions of donanemab,the patient's Aβ load decreased to 7.02 Centiloids(CL),meeting the predefined discontinuation criterion.Tau deposition showed a mild visual reduction compared with baseline.The MoCA score increased from 17 to 21,mainly in the orientation domain,while activities of daily living remained stable.Asymptomatic amyloid-related imaging abnormalities(ARIA)was detected and remained stable during follow-up. Conclusion:This case demonstrates that donanemab can achieve substantial Aβ clearance with favorable safety in real-world settings.PET-based quantitative guidance for individualized therapy duration appears feasible,though long-term follow-up is required to assess the durability of Aβ clearance and its downstream impact on Tau dynamics and clinical outcomes,providing insights for precision application of anti-Aβ therapies.