神经病学与神经康复学杂志2026，Vol.22Issue(1)：28-33,6.DOI:10.12022/jnnr.2025-0301
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
Real-world application of donanemab therapy in Alzheimer's disease:A case report on a patient who met the PET-based discontinuation threshold
耿介立 1曹雯炜 1孙卫锋 2张晨鹏 3孙雅文 4支楠 1宋雅颖 1王刚1
作者信息
- 1. 上海交通大学医学院附属仁济医院神经内科,上海 200127
- 2. 上海市黄浦区老年护理医院内科,上海 200010
- 3. 上海交通大学医学院附属仁济医院核医学科,上海 200127
- 4. 上海交通大学医学院附属仁济医院放射科,上海 200127
- 折叠
摘要
Abstract
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.关键词
阿尔茨海默病/多奈单抗/淀粉样蛋白β/Tau蛋白/正电子发射体层摄影/淀粉样蛋白相关影像学异常Key words
Alzheimer's disease/Donanemab/Amyloid-β/Tau protein/Positron emission tomography/Amyloid-related imaging abnormalities引用本文复制引用
耿介立,曹雯炜,孙卫锋,张晨鹏,孙雅文,支楠,宋雅颖,王刚..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[J].神经病学与神经康复学杂志,2026,22(1):28-33,6.
