The Geriatrician, the Primary Care Physician, Aducanumab and the FDA Decision: From Frustration to New Hope

Vellas, Bruno

doi:10.1007/s12603-021-1657-8

Cited by 8 publications

(5 citation statements)

References 18 publications

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“…This may be explained by the novelty of the drug and lack of wide clinical implementation as well as the choice of authors to publish in journals with a wider audience. However, it may also translate the geriatric field's concerns regarding current evidence on AAT as illustrated by recent statements from The American Geriatrics Society (AGS) or national stakeholders (Vellas, 2021;Harper and Lundebjerg, 2022;Kressig, 2022). This includes benefits-risk assessments of AAT as well as ethical and financial related considerations.…”

Section: Discussionmentioning

confidence: 99%

Patients with geriatric syndromes and anti-amyloid therapies: lack of consideration? An exploratory analysis of the literature

Sadlon,

Ott,

Kressig

2023

Front. Aging Neurosci.

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IntroductionPatients who should benefit from anti-amyloid therapies (AAT) are found across all geriatric settings. Yet, it remains unclear how the use of AAT in patients with geriatric syndromes, such as frailty and polypharmacy, has so far been discussed in the literature.MethodsArticles on aducanumab, gantenerumab, lecanemab, donanemab, crenezumab, solanezumab were retrieved in MEDLINE from inception to July 2023. For each article, identified geriatric relevant terms were assigned to five discussion contexts (eligibility of AAT study population, safety, prescription, patient clinical profile, alternative outcomes measurement). Article type and the involvement of geriatric healthcare professionals as an author were further extracted.ResultsOut of 538 articles, 23 (4.27%) were published in journals from the geriatric category, 44 (8.18%) included an author affiliated with a geriatric institution. One hundred and sixteen (21.56%) articles included at least one geriatric relevant term, which were mostly discussed in the context of safety and eligibility. Articles mentioning geriatric syndromes were more frequently authored by a geriatric healthcare professional (p = 0.044).DiscussionThe use of AAT in patients with geriatric syndromes has so far received poor attention in the literature raising concerns on their use in this patient group. The involvement of geriatric healthcare professionals in future studies may increase the relevance of AAT research in patients with geriatric syndromes.

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Section: Discussionmentioning

confidence: 99%

Patients with geriatric syndromes and anti-amyloid therapies: lack of consideration? An exploratory analysis of the literature

Sadlon,

Ott,

Kressig

2023

Front. Aging Neurosci.

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“…This is probably due to the fact that there was no treatment available. This has recently changed, with the FDA approving [46][47][48][49] the first drug for the treatment of Alzheimer disease (there were drugs before targeting some of the effects of the illness but not the actual illness itself).…”

Section: Discussionmentioning

confidence: 99%

Alzheimer Identification through DNA Methylation and Artificial Intelligence Techniques

Perez

Caballero-Villarraso

2021

Mathematics

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A nonlinear approach to identifying combinations of CpGs DNA methylation data, as biomarkers for Alzheimer (AD) disease, is presented in this paper. It will be shown that the presented algorithm can substantially reduce the amount of CpGs used while generating forecasts that are more accurate than using all the CpGs available. It is assumed that the process, in principle, can be non-linear; hence, a non-linear approach might be more appropriate. The proposed algorithm selects which CpGs to use as input data in a classification problem that tries to distinguish between patients suffering from AD and healthy control individuals. This type of classification problem is suitable for techniques, such as support vector machines. The algorithm was used both at a single dataset level, as well as using multiple datasets. Developing robust algorithms for multi-datasets is challenging, due to the impact that small differences in laboratory procedures have in the obtained data. The approach that was followed in the paper can be expanded to multiple datasets, allowing for a gradual more granular understanding of the underlying process. A 92% successful classification rate was obtained, using the proposed method, which is a higher value than the result obtained using all the CpGs available. This is likely due to the reduction in the dimensionality of the data obtained by the algorithm that, in turn, helps to reduce the risk of reaching a local minima.

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“…The implementation of a combination of biomarker tests, that includes imaging measures of BBB dysfunction, could aid in early diagnosis, in monitoring disease progression and in evaluating treatment response to new drugs ( Vellas, 2021 ). Figure 2C summarizes the main processes driving BBB disruption, the key factors involved and the role of BBB imaging in AD.…”

Section: Diseasementioning

confidence: 99%

Imaging blood-brain barrier dysfunction: A state-of-the-art review from a clinical perspective

Moyaert

Padrela

Morgan

et al. 2023

Front. Aging Neurosci.

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The blood-brain barrier (BBB) consists of specialized cells that tightly regulate the in- and outflow of molecules from the blood to brain parenchyma, protecting the brain’s microenvironment. If one of the BBB components starts to fail, its dysfunction can lead to a cascade of neuroinflammatory events leading to neuronal dysfunction and degeneration. Preliminary imaging findings suggest that BBB dysfunction could serve as an early diagnostic and prognostic biomarker for a number of neurological diseases. This review aims to provide clinicians with an overview of the emerging field of BBB imaging in humans by answering three key questions: (1. Disease) In which diseases could BBB imaging be useful? (2. Device) What are currently available imaging methods for evaluating BBB integrity? And (3. Distribution) what is the potential of BBB imaging in different environments, particularly in resource limited settings? We conclude that further advances are needed, such as the validation, standardization and implementation of readily available, low-cost and non-contrast BBB imaging techniques, for BBB imaging to be a useful clinical biomarker in both resource-limited and well-resourced settings.

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The Geriatrician, the Primary Care Physician, Aducanumab and the FDA Decision: From Frustration to New Hope

Cited by 8 publications

References 18 publications

Patients with geriatric syndromes and anti-amyloid therapies: lack of consideration? An exploratory analysis of the literature

Patients with geriatric syndromes and anti-amyloid therapies: lack of consideration? An exploratory analysis of the literature

Alzheimer Identification through DNA Methylation and Artificial Intelligence Techniques

Imaging blood-brain barrier dysfunction: A state-of-the-art review from a clinical perspective

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