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Abstract Details

Delphi Consensus for Implementation of Anti-amyloid mAbs in Private Practice Neurology: Recommendations from Experienced Providers
Aging, Dementia, and Behavioral Neurology
P1 - Poster Session 1 (8:00 AM-9:00 AM)
12-012
To establish recommendations for implementation of anti-amyloid monoclonal antibodies (mAbs) for treatment of Alzheimer’s disease (AD) by private practice neurologists.  
Approval of anti-amyloid mAbs has revolutionized the AD treatment landscape, but implementation of these therapies is challenged by a lack of established guidelines for treatment in private practice settings. Delphi consensus methodology has previously been used to develop clinical practice recommendations within the AD field.  
A Delphi panel of 9 expert clinicians and administrators with experience implementing anti-amyloid mAbs for treatment of AD was convened to develop practice recommendations under the direction of 2 chairs. Initial insights from a panelist survey and working group meeting were used to develop preliminary recommendations, which were then vetted for clarity and importance by panelists. 

Following completion of the Delphi process, panelists achieved consensus on 65 recommendations organized into 7 categories for which panelists faced the greatest challenges: addressing educational needs, patient identification, assessment and diagnosis, treatment, management and monitoring, administrative challenges, and other important statements. Key recommendations emphasized the importance of educating primary care physicians and other providers working with older adults to increase the urgency of identifying appropriate patients with early AD. Expert panelists recommended use of emerging blood-based biomarkers for triaging in primary care settings as well as for confirmatory diagnosis and determination of treatment eligibility, where appropriate. Consensus recommendations note that while continuation of treatment with anti-amyloid mAbs should follow prescribing information, updated guidance on maintenance treatment will be provided with continued experience and emerging clinical data.

Overall, application of these recommendations is intended to expand treatment outreach and facilitate implementation of evidence-based quality standards within private practice settings, ultimately improving access to anti-amyloid mAbs for appropriate patients with AD. 
Authors/Disclosures
Jeffrey B. Gelblum, MD, FAAN (First Choice Neurology, LLP)
PRESENTER
Dr. Gelblum has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Eisai. Dr. Gelblum has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Lilly . Dr. Gelblum has received personal compensation in the range of $5,000-$9,999 for serving on a Speakers Bureau for Eisai.
Bela Ajtai, MD Dr. Ajtai has received personal compensation in the range of $10,000-$49,999 for serving on a Speakers Bureau for Biogen.
Sarah Harlock, MBA (Dent Neurologic Group, LLP) Ms. Harlock has nothing to disclose.
J. Michael Hemphill, MD, FAAN (Savannah Neurology Specialists, PC) Dr. Hemphill has received personal compensation in the range of $100,000-$499,999 for serving on a Speakers Bureau for Eisai. Dr. Hemphill has received personal compensation in the range of $10,000-$49,999 for serving on a Speakers Bureau for Amgen. Dr. Hemphill has received personal compensation in the range of $10,000-$49,999 for serving on a Speakers Bureau for Abbvie. Dr. Hemphill has received personal compensation in the range of $10,000-$49,999 for serving on a Speakers Bureau for Bristol Myers Squibb. Dr. Hemphill has received personal compensation in the range of $10,000-$49,999 for serving on a Speakers Bureau for Alexion. Dr. Hemphill has received personal compensation in the range of $10,000-$49,999 for serving on a Speakers Bureau for EMD Serono. Dr. Hemphill has received personal compensation in the range of $10,000-$49,999 for serving on a Speakers Bureau for Argenx. Dr. Hemphill has received personal compensation in the range of $10,000-$49,999 for serving on a Speakers Bureau for TG. Dr. Hemphill has received personal compensation in the range of $10,000-$49,999 for serving on a Speakers Bureau for Sanofi. Dr. Hemphill has received personal compensation in the range of $5,000-$9,999 for serving on a Speakers Bureau for Pfizer.
Omotola A. Hope, MD (Houston Methodist Sugarland Neurology Associates) Dr. Hope has received personal compensation in the range of $10,000-$49,999 for serving on a Speakers Bureau for SK Life Sciences.
Cara Leahy Dr. Leahy has received personal compensation in the range of $10,000-$49,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Eisai . Dr. Leahy has received personal compensation in the range of $5,000-$9,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Lilly. Dr. Leahy has received personal compensation in the range of $5,000-$9,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Neurogen. Dr. Leahy has received personal compensation in the range of $10,000-$49,999 for serving on a Speakers Bureau for Eisai. Dr. Leahy has received personal compensation in the range of $10,000-$49,999 for serving on a Speakers Bureau for Lilly. The institution of Dr. Leahy has received research support from Eisai. The institution of Dr. Leahy has received research support from C2N Diagnostics. The institution of Dr. Leahy has received research support from Neurogen.
Justin S. Moon, MD, FAAN (Denver Neurological Clinic) The institution of Dr. Moon has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Eisai. The institution of Dr. Moon has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Abbvie. Dr. Moon has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Lilly. The institution of Dr. Moon has received personal compensation in the range of $500-$4,999 for serving as a Consultant for CSL Behring. The institution of Dr. Moon has received personal compensation in the range of $10,000-$49,999 for serving on a Speakers Bureau for Eisai. Dr. Moon has received personal compensation in the range of $50,000-$99,999 for serving on a Speakers Bureau for Abbvie. Dr. Moon has received personal compensation in the range of $10,000-$49,999 for serving on a Speakers Bureau for Averitas. Dr. Moon has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant with Copic .
Salvatore Napoli, MD (Neurology Center of New England) Dr. Napoli has received personal compensation in the range of $500-$4,999 for serving as a Consultant for biogen. Dr. Napoli has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Serono. Dr. Napoli has received personal compensation in the range of $500-$4,999 for serving as a Consultant for eisai. Dr. Napoli has received personal compensation in the range of $500-$4,999 for serving as a Consultant for bristol myers. Dr. Napoli has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Bristol Myers Squibb. Dr. Napoli has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for biogen. Dr. Napoli has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for bristol myers. Dr. Napoli has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for serono. Dr. Napoli has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for eisai. Dr. Napoli has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for TG Therapeutics. Dr. Napoli has received personal compensation in the range of $500-$4,999 for serving as an Expert Witness for vaccine injury.
Jose M. Rocha (FirstChoice Neurology) Mr. Rocha has received personal compensation for serving as an employee of Performance Medical Management. Mr. Rocha has received personal compensation in the range of $500-$4,999 for serving as a Consultant for EISAI. Mr. Rocha has received personal compensation in the range of $0-$499 for serving on a Speakers Bureau for AAN.
Jose Soria Lopez, MD (The Neuron Clinic) Dr. Soria Lopez has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Arrowhead Pharmaceuticals. Dr. Soria Lopez has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Biogen. Dr. Soria Lopez has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Merck. Dr. Soria Lopez has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Eisai. Dr. Soria Lopez has received personal compensation in the range of $5,000-$9,999 for serving on a Speakers Bureau for Eisai. Dr. Soria Lopez has received personal compensation in the range of $5,000-$9,999 for serving on a Speakers Bureau for Eli Lilly. The institution of Dr. Soria Lopez has received research support from Alzheimer's Association. The institution of Dr. Soria Lopez has received research support from NIH. The institution of Dr. Soria Lopez has received research support from Aribio. The institution of Dr. Soria Lopez has received research support from Eli Lilly. The institution of Dr. Soria Lopez has received research support from Annovis Bio. The institution of Dr. Soria Lopez has received research support from Bristol Myers Squibb.
David C. Weisman, MD (Abington Neurological Associates) Dr. Weisman has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Roche. Dr. Weisman has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Iqvia. Dr. Weisman has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Acumen. Dr. Weisman has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Eisai. Dr. Weisman has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Novartis. Dr. Weisman has received personal compensation in the range of $5,000-$9,999 for serving on a Scientific Advisory or Data Safety Monitoring board for eisai. Dr. Weisman has received personal compensation in the range of $5,000-$9,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Lantheus. Dr. Weisman has received personal compensation in the range of $50,000-$99,999 for serving on a Speakers Bureau for Eisai. Dr. Weisman has received personal compensation in the range of $10,000-$49,999 for serving on a Speakers Bureau for Lilly. The institution of Dr. Weisman has received research support from Eisai. The institution of Dr. Weisman has received research support from Biogen. The institution of Dr. Weisman has received research support from Roche. The institution of Dr. Weisman has received research support from Vivoryon. The institution of Dr. Weisman has received research support from Lilly. The institution of Dr. Weisman has received research support from Acumen. The institution of Dr. Weisman has received research support from Cerevel. The institution of Dr. Weisman has received research support from Sage. The institution of Dr. Weisman has received research support from Annovis. The institution of Dr. Weisman has received research support from Serono. The institution of Dr. Weisman has received research support from Acadia. The institution of Dr. Weisman has received research support from Alnylam. The institution of Dr. Weisman has received research support from Ventus. The institution of Dr. Weisman has received research support from Cognition. Dr. Weisman has received intellectual property interests from a discovery or technology relating to health care. Dr. Weisman has received intellectual property interests from a discovery or technology relating to health care. Dr. Weisman has received personal compensation in the range of $500-$4,999 for serving as a Peripheral and Central Nervous System Drugs Advisory Committee with FDA.