A single-center retrospective cohort study reported that about half of patients receiving lecanemab for early Alzheimer’s discontinued the therapy or did not transition to maintenance by 18 months. The remaining patients shifted into a maintenance phase, while discontinuations occurred before or at the transition window. The data highlight real-world persistence challenges for anti-amyloid strategies and can inform counseling, monitoring plans, and future trial design around longer-term tolerability and adherence.