How many patients are eligible for disease-modifying treatment in Alzheimer’s disease? A French national observational study over 5 years

Archive ouverte

Epelbaum, Stéphane | Paquet, Claire | Hugon, Jacques | Dumurgier, Julien | Wallon, David | Hannequin, Didier | Jonveaux, Thérèse | Besozzi, Annick | Pouponneau, Stéphane | Hommet, Caroline | Blanc, Frédéric | Berly, Laetitia | Julian, Adrien | Paccalin, Marc | Pasquier, Florence | Bellet, Julie | Boutoleau-Bretonnière, Claire | Charriau, Thiphaine | Rouaud, Olivier | Madec, Olivier | Mouton, Aurélie | David, Renaud | Bekadar, Samir | Fabre, Roxane | Liegey, Emmanuelle | Deberdt, Walter | Robert, Philippe | Dubois, Bruno

Edité par CCSD ; BMJ Publishing Group -

International audience. Objective We aimed to study the epidemiology of the prodromal and mild stages of Alzheimer’s disease (AD) patients who are eligible for clinical trials with disease-modifying therapies.Settings We analysed two large complementary databases to study the incidence and characteristics of this population on a nationwide scope in France from 2014 to 2018. The National Alzheimer Database contains data from 357 memory centres and 90 private neurologists. Data from 2014 to 2018 have been analysed.Participants Patients, 50–85 years old, diagnosed with AD who had an Mini-Mental State Exam (MMSE) score of ≥20 were included. We excluded patients with mixed and non-AD neurocognitive disorders.Primary outcome measure Descriptive statistics of the population of interest was the primary measure.Results In the National Alzheimer Database, 550 198 patients were assessed. Among them, 72 174 (13.1%) were diagnosed with AD and had an MMSE ≥20. Using corrections for specificity of clinical diagnosis of AD, we estimated that about 50 000 (9.1%) had a prodromal or mild AD. In the combined electronic clinical records database of 11 French expert memory centres, a diagnosis of prodromal or mild AD, certified by the use of cerebrospinal fluid AD biomarkers, could be established in 195 (1.3%) out of 14 596 patients.Conclusions AD was not frequently diagnosed at a prodromal or mild dementia stage in France in 2014 to 2018. Diagnosis rarely relied on a pathophysiological marker even in expert memory centres. National databases will be valuable to monitor early stage AD diagnosis efficacy in memory centres when a disease-modifying treatment becomes available.

Suggestions

Du même auteur

SORL1 rare variants: a major risk factor for familial early-onset Alzheimer’s disease

Archive ouverte | Nicolas, Gaël | CCSD

International audience. The SORL1 protein plays a protective role against the secretion of the amyloid β peptide, a key event in the pathogeny of Alzheimer's disease. We assessed the impact of SORL1 rare variants in...

Cognitive and imaging markers in non-demented subjects attending a memory clinic: study design and baseline findings of the MEMENTO cohort

Archive ouverte | Dufouil, Carole | CCSD

International audience. AbstractBackgroundThe natural history and disease mechanisms of Alzheimer’s disease and related disorders (ADRD) are still poorly understood. Very few resources are available to scrutinise pa...

Added value of 18F-florbetaben amyloid PET in the diagnostic workup of most complex patients with dementia in France: A naturalistic study

Archive ouverte | Ceccaldi, Mathieu | CCSD

International audience. IntroductionAlthough some studies have previously addressed the clinical impact of amyloid positron emission tomography (PET), none has specifically addressed its selective and hierarchical i...

Chargement des enrichissements...