Patient eligibility for amyloid-targeting immunotherapies in Alzheimer's disease.

IF 4.3 Q2 BUSINESS
Jurij Rosen, Frank Jessen
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引用次数: 0

Abstract

Background: Amyloid beta (Aβ) targeting immunotherapies have evolved as promising treatment options for patients with early symptomatic Alzheimer's disease (AD). Understanding how eligibilty criteria impact on the number of patients potentially qualifying for treatment is of high relevance for designing diagnostic workflows in clinical practice and for estimating required ressources and costs.

Objectives: We aimed at estimating the number of potentially eligible patients for treatment with the Aβ targeting antibodies aducanumab, lecanemab and donanemab in a specialized center real-world sample by the applying the phase 3 clinical trial and the appropriate use recommendations (AUR) inclusion and exclusion criteria to the data set. The post-mortem report was used for defining amyloid positivity and the presence of AD pathology in this study.

Design: Retrospective, descriptive study.

Setting: The multicenter National Alzheimer's Coordinating Center-Uniform Data Set (NACC-UDS) and Neuropathology Data Set (NACCNP).

Participants: We included all 3,343 participants of the NACC dataset with available post-mortem pathology reports.

Measurements/results: 887 participants were potential candidates for anti-Aβ immunotherapy as they presented with amnestic mild cognitive impairment or mild dementia and the clinical diagnosis of AD (amnestic AD syndrome). Applying the criterion of amyloid positivity (post mortem report) and the clinical trial inclusion and exclusion criteria to this sample resulted in 83 (9 %), 275 (31 %), and 172 (19 %) participants eligible for treatment with aducanumab, lecanemab, and donanemab, respectively. Applying the criteria of the AUR resulted in 242 (27 %) and 266 (30 %) participants eligible for treatment with aducanumab or lecanemab, respectively. The eligible participant groups for each antibody showed partial, but not full overlap. Co-pathologies were common.

Conclusions: The number of eligible participants varies between the different antibodies and the selected groups only partly overlap, indicating partly different groups of eligible participants for each antibody. Since not all inclusion and exclusion criteria can be extracted from the NACC-UDS dataset, the real number of eligible patients will be smaller.

阿尔茨海默病中淀粉样蛋白靶向免疫疗法的患者资格
背景:针对β淀粉样蛋白(Aβ)的免疫疗法已经发展成为早期症状性阿尔茨海默病(AD)患者的有希望的治疗选择。了解资格标准如何影响可能符合治疗条件的患者数量,对于设计临床实践中的诊断工作流程以及估计所需的资源和成本具有高度相关性。目的:我们的目的是通过应用3期临床试验和适当使用建议(AUR)纳入和排除标准对数据集进行纳入和排除,估计在一个专门的中心真实世界样本中可能符合使用靶向抗体aducanumab、lecanemab和donanemab治疗的患者数量。在本研究中,尸检报告用于确定淀粉样蛋白阳性和AD病理的存在。设计:回顾性描述性研究。设置:多中心国家阿尔茨海默病协调中心统一数据集(NACC-UDS)和神经病理学数据集(NACCNP)。参与者:我们纳入了所有3343名NACC数据集的参与者,并提供了可用的死后病理报告。测量/结果:887名参与者是抗a β免疫治疗的潜在候选者,因为他们表现为遗忘性轻度认知障碍或轻度痴呆,并且临床诊断为AD(遗忘性AD综合征)。将淀粉样蛋白阳性标准(尸检报告)和临床试验纳入和排除标准应用于该样本,分别有83(9%)、275(31%)和172(19%)参与者符合aducanumab、lecanemab和donanemab的治疗条件。应用AUR标准,分别有242名(27%)和266名(30%)参与者符合aducanumab或lecanemab治疗的条件。每种抗体的符合条件的参与者组显示部分重叠,但不是完全重叠。共病很常见。结论:不同抗体的合格参与者数量不同,所选组仅部分重叠,表明每种抗体的合格参与者群体部分不同。由于并非所有的纳入和排除标准都可以从NACC-UDS数据集中提取出来,因此符合条件的患者的实际数量将会更少。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
The Journal of Prevention of Alzheimer's Disease
The Journal of Prevention of Alzheimer's Disease Medicine-Psychiatry and Mental Health
CiteScore
9.20
自引率
0.00%
发文量
0
期刊介绍: The JPAD Journal of Prevention of Alzheimer’Disease will publish reviews, original research articles and short reports to improve our knowledge in the field of Alzheimer prevention including: neurosciences, biomarkers, imaging, epidemiology, public health, physical cognitive exercise, nutrition, risk and protective factors, drug development, trials design, and heath economic outcomes.JPAD will publish also the meeting abstracts from Clinical Trial on Alzheimer Disease (CTAD) and will be distributed both in paper and online version worldwide.We hope that JPAD with your contribution will play a role in the development of Alzheimer prevention.
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