What would prompt discontinuing treatment versus switching or sequencing treatment in patients treated with an anti-amyloid therapy for Alzheimer's?

There are guidelines to stop the medication due to ARIA. In my practice, we only discontinued treatment once, and it was due to the personal choice of the patient and family. I do not see a reason to switch from one medication to the other based on the data we currently have.

To be sure, there is virtually no evidence of outcomes on switching from one antibody to another. If treatment discontinuation occurred due to ARIA, I would strongly discourage rechallenge with another agent. There is no rationale for discontinuing lecanemab or donanemab for lack of efficacy on clin...

I would discontinue therapy if:

1. If patients wish to discontinue.
2. Development of side effects including ARIA.
3. New medical problems warranting treatments that are contraindicated with concurrent anti-amyloid treatment.

I do not offer sequencing therapy with the alternative agent if initial therapy i...

Since any severity of ARIA only guides us to suspend dosing, and if stable, continue in consultation with the patient. I would think that the only answer to this question would be progression to moderate stage dementia (CDR 1.5), as those were exclusions in the AAA studies, along with, apparently, a...