Abstract Details

Title Real-world Delays in Anti-amyloid Therapy Initiation Following Diagnosis of Early-stage Alzheimer’s Disease

Topic Aging, Dementia, and Behavioral Neurology

Presentation(s) S1 - New Perspectives on Alzheimer's Therapeutics (2:12 PM-2:24 PM)

Poster/Presentation
Number 007

Objective

To investigate real world factors contributing to delays of anti-amyloid therapy (AAT)

Background AATs are FDA-approved, disease-modifying treatments for early-stage Alzheimer’s disease (AD). Evidence suggests that earlier initiation results in better outcomes, but access can be slowed by real-world barriers.

Design/Methods We retrospectively reviewed 154 AD patients treated with AATs at an academic center. Data relating to diagnosis, biomarker type, initial infusion date, distance from infusion center, medical insurance, referral source, and ApoE status were abstracted from the electronic medical record. The diagnosis time-point was designated by date of biomarker confirmation. Group differences in median time from diagnosis to treatment initiation were assessed using the Mann–Whitney U test, with significance set at p < 0.05.

Results Median time between biomarker diagnosis and first lecanemab infusion decreased from 212 (Q3-2023) to 140.5 days (Q3-2025) whereas delay times for donanemab decreased from 129 (Q2-2025) to 91 days (Q3-2025) over the course of program implementation. Patients referred from external practices experienced markedly longer delays compared to those referred internally (p < 0.000001). There was a significantly longer median time to treatment for patients with dementia than those with MCI (p < 0.00001). Non-Medicare insurance was associated with longer delays compared to Medicare (p = 0.021). APOE e4/e4 carriers experienced modest but statistically significant treatment delays relative to non-homozygotic patients (p = 0.004). There was no effect of distance to academic center on treatment delay.

Conclusions Time to starting AATs following diagnosis improved with longitudinal experience. Median time to AAT initiation was significantly impacted by referral type, diagnosis, insurance status, and APOE genotype. Patient geographical location did not significantly affect time to treatment. AD patients with private insurance, patients referred from smaller healthcare systems, and patients with higher ARIA risk are most vulnerable to treatment delays and may experience disparities in accessing AATs.

Authors/Disclosures
Michael H. Rosenbloom, MD, FAAN PRESENTER	Dr. Rosenbloom has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Esai. Dr. Rosenbloom has received personal compensation in the range of $10,000-$49,999 for serving on a Speakers Bureau for Eisai.
Manjot Singh, MD	Dr. Singh has nothing to disclose.
Andrea Schnee, RN	Mrs. Schnee has nothing to disclose.

��ɫ��

��ɫ��