Karlawish Jason H T, Clark Christopher M
Department of Medicine, Division of Geriatrics, Alzheimer's Disease Center, Center for Bioethics and Leonard Davis Institute of Health Economics, University of Pennsylvania, Philadelphia 19104, USA.
Neurobiol Aging. 2002 Nov-Dec;23(6):1043-9. doi: 10.1016/s0197-4580(02)00119-7.
This essay addresses the challenges of clinical trials to develop treatments for Alzheimer's Disease (AD). The issues covered are enrolling subjects, defining clinically meaningful endpoints, and making the claim that a drug slows the progression of the disease. The perspective to address these challenges is that dementia research should embrace a biopsychosocial model for drug development. In this model, the patient and caregiver are seen as interrelated subjects of both treatment and research and outcome measures reflect biomarkers of the disease, the functional morbidity of AD and the distress of caregiving.
本文探讨了开展阿尔茨海默病(AD)治疗临床试验所面临的挑战。所涵盖的问题包括招募受试者、定义具有临床意义的终点,以及宣称某种药物可减缓疾病进展。应对这些挑战的观点是,痴呆症研究应采用生物心理社会模型进行药物研发。在该模型中,患者和护理人员被视为治疗与研究的相互关联的主体,而结果指标反映疾病的生物标志物、AD的功能损害以及护理的痛苦程度。