Alzheimer's prevention initiative: A plan to accelerate the evaluation of presymptomatic treatments

Eric M. Reiman, Jessica B S Langbaum, Adam S. Fleisher, Richard John Caselli, Kewei Chen, Napatkamon Ayutyanont, Yakeel T. Quiroz, Kenneth S. Kosik, Francisco Lopera, Pierre N. Tariot

Research output: Chapter in Book/Report/Conference proceedingChapter

5 Citations (Scopus)

Abstract

There is an urgent need to find effective presymptomatic Alzheimer's disease (AD) treatments that reduce the risk of AD symptoms or prevent them completely. It currently takes too many healthy people, too much money and too many years to evaluate the range of promising presymptomatic treatments using clinical endpoints. We have used brain imaging and other measurements to track some of the earliest changes associated with the predisposition to AD. We have proposed the Alzheimer's Prevention Initiative (API) to evaluate investigational amyloid-modifying treatments in healthy people who, based on their age and genetic background, are at the highest imminent risk of developing symptomatic AD using brain imaging, cerebrospinal fluid (CSF), and cognitive endpoints. In one trial, we propose to study AD-causing presenilin 1 [PS1] mutation carriers from the world's largest early-onset AD kindred in Antioquia, Colombia, close to their estimated average age at clinical onset. In another trial, we propose to study apolipoprotein E (APOE) ε4 homozygotes (and possibly heterozygotes) close to their estimated average age at clinical onset. The API has several goals: 1) to evaluate investigational AD-modifying treatments sooner than otherwise possible; 2) to determine the extent to which the treatment's brain imaging and other biomarker effects predict a clinical benefit-information needed to help qualify biomarker endpoints for use in pivotal prevention trials; 3) to provide a better test of the amyloid hypothesis than clinical trials in symptomatic patients, when these treatments may be too little too late to exert their most profound effect; 4) to establish AD prevention registries needed to support these and other presymptomatic AD trials; and 5) to give those individuals at highest imminent risk of AD symptoms access to the most promising investigational treatments in clinical trials.

Original languageEnglish (US)
Title of host publicationAdvances in Alzheimer's Disease
Pages589-597
Number of pages9
Volume2
DOIs
StatePublished - 2011

Publication series

NameAdvances in Alzheimer's Disease
Volume2
ISSN (Print)22105727
ISSN (Electronic)22105735

Fingerprint

Alzheimer Disease
Neuroimaging
Asymptomatic Diseases
Age of Onset
Amyloid
Therapeutics
Biomarkers
Clinical Trials
Presenilin-1
Apolipoprotein E4
Investigational Therapies
Colombia
Homozygote
Heterozygote
Cerebrospinal Fluid
Registries
Mutation

Keywords

  • apolipoprotein E
  • biomarkers
  • Brain imaging
  • cerebral spinal fluid
  • clinical trials
  • early-onset Alzheimer's disease
  • late-onset Alzheimer's disease
  • presenilin 1
  • presymptomatic Alzheimer's disease
  • surrogate markers

ASJC Scopus subject areas

  • Clinical Neurology

Cite this

Reiman, E. M., Langbaum, J. B. S., Fleisher, A. S., Caselli, R. J., Chen, K., Ayutyanont, N., ... Tariot, P. N. (2011). Alzheimer's prevention initiative: A plan to accelerate the evaluation of presymptomatic treatments. In Advances in Alzheimer's Disease (Vol. 2, pp. 589-597). (Advances in Alzheimer's Disease; Vol. 2). https://doi.org/10.3233/978-1-60750-793-2-589

Alzheimer's prevention initiative : A plan to accelerate the evaluation of presymptomatic treatments. / Reiman, Eric M.; Langbaum, Jessica B S; Fleisher, Adam S.; Caselli, Richard John; Chen, Kewei; Ayutyanont, Napatkamon; Quiroz, Yakeel T.; Kosik, Kenneth S.; Lopera, Francisco; Tariot, Pierre N.

Advances in Alzheimer's Disease. Vol. 2 2011. p. 589-597 (Advances in Alzheimer's Disease; Vol. 2).

Research output: Chapter in Book/Report/Conference proceedingChapter

Reiman, EM, Langbaum, JBS, Fleisher, AS, Caselli, RJ, Chen, K, Ayutyanont, N, Quiroz, YT, Kosik, KS, Lopera, F & Tariot, PN 2011, Alzheimer's prevention initiative: A plan to accelerate the evaluation of presymptomatic treatments. in Advances in Alzheimer's Disease. vol. 2, Advances in Alzheimer's Disease, vol. 2, pp. 589-597. https://doi.org/10.3233/978-1-60750-793-2-589
Reiman EM, Langbaum JBS, Fleisher AS, Caselli RJ, Chen K, Ayutyanont N et al. Alzheimer's prevention initiative: A plan to accelerate the evaluation of presymptomatic treatments. In Advances in Alzheimer's Disease. Vol. 2. 2011. p. 589-597. (Advances in Alzheimer's Disease). https://doi.org/10.3233/978-1-60750-793-2-589
Reiman, Eric M. ; Langbaum, Jessica B S ; Fleisher, Adam S. ; Caselli, Richard John ; Chen, Kewei ; Ayutyanont, Napatkamon ; Quiroz, Yakeel T. ; Kosik, Kenneth S. ; Lopera, Francisco ; Tariot, Pierre N. / Alzheimer's prevention initiative : A plan to accelerate the evaluation of presymptomatic treatments. Advances in Alzheimer's Disease. Vol. 2 2011. pp. 589-597 (Advances in Alzheimer's Disease).
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