{
  "abstract": "With the European authorisation of lecanemab and donanemab, Italy is entering the era of disease-modifying therapy for early symptomatic Alzheimer's disease. The Italian Expert Panel on Alzheimer (EPA), which convened 21 scientific societies and patient associations and published a first set of intersocietal recommendations in 2025, was reconvened in Rome on 24 January 2026 (EPA2) to address the operational gaps that had emerged during the implementation of that document. A modified Delphi process was adopted to formalise consensus on the most controversial points raised during the meeting. Thirty-six declarative statements covering five domains, namely the tiered organisation of the Centres for Cognitive Disorders and Dementia (CDCD), clinical staging and treatment monitoring, eligibility considerations in mild cognitive impairment and atypical phenotypes, composition of the multidisciplinary team, and magnetic resonance imaging thresholds, ARIA monitoring and biomarker pathway, were submitted to a multidisciplinary panel of experts. Strong agreement was reached on the large majority of statements, providing quantitative endorsement for a competence-based reorganisation of the CDCD network, the harmonised use of the Clinical Dementia Rating, an explicit composition of the multidisciplinary team, trial-aligned magnetic resonance imaging eligibility criteria with a move towards risk-adapted ARIA monitoring, and a stepwise biomarker pathway integrating plasma assays, cerebrospinal fluid analysis on automated platforms and amyloid positron emission tomography. The document provides Italian regional and national health systems, prescribing centres and reimbursing authorities with a quantitative blueprint for the appropriate, equitable and sustainable use of anti-amyloid monoclonal antibodies in clinical practice.",
  "abstract_shown": true,
  "affiliations": [
    "Neurology Unit, Department of Medical, Surgical and Health Sciences, University of Trieste, Trieste, Italy; Neurology Clinic, Department of Medicine, Surgery and Health Sciences, Azienda Sanitaria Universitaria Giuliano Isontina, Trieste, Italy. Electronic address: alberto.benussi@units.it.",
    "Neuroimaging Research Unit, Division of Neuroscience, IRCCS San Raffaele Scientific Institute, Milan, Italy; Neurology Unit, IRCCS San Raffaele Scientific Institute, Milan, Italy; Vita-Salute San Raffaele University, Milan, Italy.",
    "Department of Biomedicine, Neurosciences and Advanced Diagnostics, Institute of Clinical Biochemistry, Clinical Molecular Medicine, and Clinical Laboratory Medicine, University of Palermo, Palermo, Italy; Department of Laboratory Medicine, University Hospital \"Paolo Giaccone\", Palermo, Italy.",
    "Unit of Geriatrics, Medical Department, San Giovanni-Addolorata Hospital, Rome, Italy.",
    "Modena Local Health Authority (Azienda USL Modena), Modena, Italy; Italian Society of Leadership and Management in Medicine (SIMM), Rome, Italy.",
    "Department of Laboratory Medicine, Hospital \"Ca' Foncello\", Treviso, Italy.",
    "Cognitive Neuropsychology Centre, ASST Grande Ospedale Metropolitano Niguarda, Milan, Italy; Department of Brain and Behavioral Sciences, University of Pavia, Pavia, Italy; NeuroMi - Milan Center for Neuroscience, Milan, Italy.",
    "School of Medicine and Surgery, University of Milano-Bicocca, Milan, Italy; Acute Geriatric Unit, Fondazione IRCCS San Gerardo dei Tintori, Monza, Italy.",
    "Department of Medicine and Aging Sciences, \"G. d'Annunzio\" University of Chieti-Pescara, Chieti, Italy.",
    "\"Rita Levi-Montalcini\" Department of Neuroscience, University of Torino, Turin, Italy; Neurology Unit 2U, Azienda Ospedaliero-Universitaria Città della Salute e della Scienza di Torino, Turin, Italy.",
    "Italian College of General Practitioners and Primary Care Professionals (SIMG), Florence, Italy.",
    "Department of Human Neuroscience, Sapienza University of Rome, Rome, Italy.",
    "Department of Neuroscience, University of Padova, Padova, Italy; Padova Neuroscience Center, University of Padova, Padova, Italy.",
    "Neuroradiology Unit & CERMAC, IRCCS Ospedale San Raffaele, Milan, Italy.",
    "IUSS Cognitive Neuroscience (ICoN) Center, University Institute of Advanced Studies IUSS, Pavia, Italy; IRCCS Istituto Auxologico Italiano, Milan, Italy.",
    "Department of Drug and Health Sciences, University of Catania, Catania, Italy; Oasi Research Institute-IRCCS, Troina, Italy.",
    "Padova Neuroscience Center, University of Padova, Padova, Italy; Nuclear Medicine Unit, Department of Medicine (DIMED), University Hospital of Padova, Padova, Italy.",
    "Neuroradiology Unit, University Hospital \"Federico II\", Naples, Italy.",
    "Neuroradiology Unit, Department of Translational Research on New Technologies in Medicine and Surgery, University of Pisa, Pisa, Italy; Neuroradiology Unit, Azienda Ospedaliero-Universitaria Pisana, Pisa, Italy.",
    "Australian Institute for Suicide Research and Prevention, Griffith University, Nathan, QLD, Australia; Slovene Centre for Suicide Research, University of Primorska, Koper, Slovenia; De Leo Fund, Padova, Italy.",
    "Vita-Salute San Raffaele University, Milan, Italy; Neuroradiology Unit & CERMAC, IRCCS Ospedale San Raffaele, Milan, Italy.",
    "Section of Neurology, Department of Medicine and Surgery, University of Perugia, Perugia, Italy.",
    "Dipartimento Immagini, SC Radiologia, Ospedale Villa Scassi - IRCCS AOM, Genova, Italy.",
    "Unit of Medical Genetics, IRCCS Ospedale Policlinico San Martino, Genoa, Italy; Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics and Maternal and Child Health (DINOGMI), University of Genova, Genoa, Italy.",
    "Functional and Molecular Neuroimaging Unit, IRCCS Istituto delle Scienze Neurologiche di Bologna, Bologna, Italy; Department of Biomedical and Neuromotor Sciences (DIBINEM), University of Bologna, Bologna, Italy.",
    "Center for Neurodegenerative Diseases and the Aging Brain, University of Bari \"Aldo Moro\", Tricase-Lecce, Italy; Department of Translational Biomedicine and Neuroscience (DiBraiN), University of Bari \"Aldo Moro\", Bari, Italy.",
    "Department of Pharmacological and Biomolecular Sciences \"Rodolfo Paoletti\", University of Milan, Milan, Italy.",
    "Memory Clinic, Fondazione Policlinico Universitario \"A. Gemelli\" IRCCS, Rome, Italy; Department of Psychology, Catholic University of the Sacred Heart, Milan, Italy.",
    "Federazione Italiana Medici di Medicina Generale (FIMMG), Rome, Italy.",
    "Nuclear Medicine Unit, AOU Città della Salute e della Scienza di Torino, Turin, Italy; Department of Medical Sciences, University of Turin, Turin, Italy.",
    "Division of Gerontology and Geriatrics, Department of Medicine and Surgery, University of Perugia, Perugia, Italy; Division of Clinical Geriatrics, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden.",
    "Division of Geriatric and Intensive Care Medicine, University of Florence & Azienda Ospedaliero-Universitaria Careggi, Florence, Italy.",
    "Neurology, Neurophysiopathology, and Stroke Unit, Santo Stefano Hospital, Prato, Italy.",
    "Neurology and Stroke Unit, Luigi Sacco University Hospital, Milan, Italy; Department of Biomedical and Clinical Sciences, Neuroscience Research Center, University of Milan, Milan, Italy; Department of Neurorehabilitation Sciences, Casa di Cura Igea, Milan, Italy.",
    "Department of Health Sciences (DISSAL), University of Genoa, Genoa, Italy; Neuroradiology Unit, IRCCS Ospedale Policlinico San Martino, Genoa, Italy.",
    "Department of Neuroscience, Psychology, Drug Research and Child Health (NEUROFARBA), University of Florence, Florence, Italy; IRCCS Fondazione Don Carlo Gnocchi, Florence, Italy; Fondazione Villa Serena per la Ricerca, Città Sant'Angelo, Pescara, Italy.",
    "Associazione Italiana Malattia Alzheimer-AIMA, Milan, Italy.",
    "Department of Biotechnological and Applied Clinical Sciences, University of L'Aquila, L'Aquila, Italy; Neuroradiology Unit, San Salvatore Hospital, L'Aquila, Italy.",
    "Department of Advanced Medical and Surgical Sciences, University of Campania \"Luigi Vanvitelli\", Naples, Italy.",
    "Neurology Unit and Centre for Cognitive Disorders and Dementia, ARNAS Garibaldi, Catania, Italy."
  ],
  "article_type": "research article",
  "arxiv": null,
  "author_total": 46,
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      "name": "Federica Agosta"
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      "name": "Luisa Agnello"
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      "name": "Alba Rosa Alfano"
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      "name": "Mattia Altini"
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      "name": "Stefania Basilico"
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      "name": "Giuseppe Bellelli",
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      "name": "Laura Bonanni"
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      "name": "Gabriella Bottini"
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      "name": "Marco Bozzali"
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    {
      "affs": [
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      "name": "Ovidio Brignoli"
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      "name": "Giuseppe Bruno"
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      "name": "Annachiara Cagnin"
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      "name": "Sonia Francesca Calloni"
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      "name": "Stefano F Cappa"
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      "name": "Filippo Caraci"
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      "name": "Diego Cecchin"
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    {
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      "name": "Marcello Ciaccio"
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    {
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      "name": "Sirio Cocozza"
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        18
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      "name": "Mirco Cosottini"
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    {
      "affs": [
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      "name": "Diego De Leo"
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    {
      "affs": [
        20
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      "name": "Andrea Falini"
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    {
      "affs": [
        21
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      "name": "Lorenzo Gaetani"
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    {
      "affs": [
        22
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      "name": "Nicoletta Gandolfo"
    },
    {
      "affs": [
        23
      ],
      "name": "Fabio Gotta"
    },
    {
      "affs": [
        24
      ],
      "name": "Raffaele Lodi"
    },
    {
      "affs": [
        25
      ],
      "name": "Giancarlo Logroscino"
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    {
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        26
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      "name": "Elena Marcello"
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    {
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        27
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      "name": "Camillo Marra"
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    {
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        28
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      "name": "Walter Marrocco"
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    {
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      "name": "Silvia Morbelli"
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    {
      "affs": [
        30
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      "name": "Patrizia Mecocci"
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    {
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      "name": "Enrico Mossello"
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      "name": "Lorenzo Palleschi"
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        32
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      "name": "Pasquale Palumbo"
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        33
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      "name": "Leonardo Pantoni"
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    {
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      "name": "Lucilla Parnetti"
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    {
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        34
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      "name": "Luca Roccatagliata"
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    {
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      "name": "Sandro Sorbi"
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    {
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      "name": "Patrizia Spadin"
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    {
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        37
      ],
      "name": "Alessandra Splendiani"
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    {
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        38
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      "name": "Alessandro Tessitore"
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    {
      "affs": [
        31
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      "name": "Andrea Ungar"
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    {
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        39
      ],
      "name": "Giuseppe Zappalà"
    },
    {
      "name": "Alessandro Padovani"
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  ],
  "bibtex": "https://research.draconitic.com/paper/332c0k38mwyzn.bib",
  "cited_by": 0,
  "doi": "10.1016/j.tjpad.2026.100685",
  "fulltext_url": "https://europepmc.org/articles/PMC13693314",
  "id": "332c0k38mwyzn",
  "issns": [
    "2426-0266"
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  "landing_url": "https://europepmc.org/article/MED/42880054",
  "language": "eng",
  "licence": "CC-BY-NC-ND",
  "licence_label": "CC BY-NC-ND",
  "licence_source": "article",
  "licence_url": "https://creativecommons.org/licenses/by-nc-nd/4.0/",
  "metadata_licence": null,
  "native_subjects": [
    [
      "openalex",
      "2737|Alzheimer's disease research and treatments"
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  "openalex": "W7222327063",
  "pdf_url": "https://europepmc.org/articles/PMC13693314?pdf=render",
  "pmcid": "PMC13693314",
  "pmid": "42880054",
  "published": "2026-10-15",
  "publisher": null,
  "ris": "https://research.draconitic.com/paper/332c0k38mwyzn.ris",
  "sources": [
    {
      "first_seen": "2026-10-30T12:18:46Z",
      "native_id": "MED:42880054",
      "source": "europepmc",
      "url": "https://europepmc.org/article/MED/42880054"
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  "subjects": [
    {
      "field": "medicine",
      "origin": "openalex:2737|Alzheimer's disease research and treatments",
      "subfield": "physiology"
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  ],
  "title": "Updated Italian intersocietal recommendations for the appropriate use of anti-amyloid monoclonal antibodies in Alzheimer's disease.",
  "title_text": "Updated Italian intersocietal recommendations for the appropriate use of anti-amyloid monoclonal antibodies in Alzheimer's disease.",
  "type": "peer-reviewed",
  "updated_at": "2026-10-30T12:18:46Z",
  "url": "https://research.draconitic.com/paper/332c0k38mwyzn",
  "venue": "The journal of prevention of Alzheimer's disease",
  "versions": []
}