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AD/PD 2023 | Prospects for Alzheimer’s disease monitoring and treatment in 2023

Stephen P. Salloway, MD, MS, Butler Hospital & Warren Alpert Medical School of Brown University, Providence, RI, reviews the prospects for Alzheimer’s disease treatment in 2023. The rapid developments seen in the anti-amyloid treatment space are set to continue, as release of the Phase III donanemab data is expected this year, as well as a decision by the FDA on whether to grant full approval of lecanemab. The Alzheimer’s Network for Treatment and Diagnostics (ALZ-NET) is a new domain this year, designed for monitoring the safety and efficacy of disease modifying therapies in clinical practice. The network will collect real-world longitudinal evidence from individuals treated with new FDA-approved therapies, which will be used by health care providers and researchers to improve patient care and guide future treatments. Finally, new blood tests that assess amyloid ratios and isomers of phosphorylated tau (p-tau) are becoming increasingly available, for clinical trial screening and diagnostics. This interview took place at the AD/PD™ 2023 congress in Gothenburg, Sweden.

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Transcript (edited for clarity)

Hopefully soon, the donanemab Phase III data will be released and so that’s the next major clinical trial to read out. Donanemab had encouraging results in Phase II. That’s another amyloid lowering antibody and we’ll see what the results show and if they’re positive, I’m sure they will plan on seeking FDA approval. Probably the biggest thing that’s coming is there’s going to be a decision by FDA whether or not to grant full approval for lecanemab and CMS will then decide how to cover it and to what degree they’re going to cover it and what restrictions might be placed on that for either lecanemab or donanemab...

Hopefully soon, the donanemab Phase III data will be released and so that’s the next major clinical trial to read out. Donanemab had encouraging results in Phase II. That’s another amyloid lowering antibody and we’ll see what the results show and if they’re positive, I’m sure they will plan on seeking FDA approval. Probably the biggest thing that’s coming is there’s going to be a decision by FDA whether or not to grant full approval for lecanemab and CMS will then decide how to cover it and to what degree they’re going to cover it and what restrictions might be placed on that for either lecanemab or donanemab. So that’s really important.

And I want to make your viewers aware about ALZ-NET, which is a new network that the Alzheimer’s Association put in place with the American College of Radiology to help monitor safety and efficacy of patients who go on disease modifying treatments. And I would encourage all clinicians to enroll patients in ALZ-NET who go on these medicines or who are being considered for them so we can track it and make sure that it’s safe and make any modifications and help clinicians provide better care. So this this will help us really improve the standard of care for Alzheimer’s disease.

I guess the biggest thing that’s coming in addition to everything I’ve just said, which is a lot, are the new blood tests that are already here. I used to say they’re on the horizon, but they’re here now and there are different types. They they look at amyloid ratios in the blood. They look at different isomers of phospho-tau. They’re looking really good and there are different types. One uses a mass spec technique, another use immunoassays. And that’s really going to help with screening for these disease modifying treatments, screening for clinical trials and also to improve diagnosis and clinical practice, so clinicians should keep their eyes out.

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