Department of Neurosciences, UCSD, 9500 Gilman Drive M/C 0949, La Jolla, CA 92093, USA
Neurology. 2011 Jan 18;76(3):280-6. doi: 10.1212/WNL.0b013e318207b1b9. Epub 2010 Dec 22.
A large number of promising candidate disease-modifying treatments for Alzheimer disease (AD) continue to advance into phase II and phase III testing. However, most completed trials have failed to demonstrate efficacy, and there is growing concern that methodologic difficulties may contribute to these clinical trial failures. The optimal time to intervene with such treatments is probably in the years prior to the onset of dementia, before the neuropathology has progressed to the advanced stage corresponding to clinical dementia.
An international task force of individuals from academia, industry, nonprofit foundations, and regulatory agencies was convened to discuss optimal trial design in early (predementia) AD.
General consensus was reached on key principles involving the scope of the AD diagnosis, the selection of subjects for trials, outcome measures, and analytical methods.
A consensus has been achieved in support of the testing of candidate treatments in the early (predementia) AD population.
大量有前景的阿尔茨海默病(AD)治疗候选药物继续进入 II 期和 III 期试验。然而,大多数已完成的试验未能证明其疗效,人们越来越担心方法学上的困难可能导致这些临床试验的失败。用这种治疗方法进行干预的最佳时间可能是在痴呆症发作前的几年,在神经病理学进展到与临床痴呆症相对应的晚期之前。
一个由学术界、工业界、非营利基金会和监管机构的个人组成的国际工作组被召集来讨论早期(痴呆前)AD 的最佳试验设计。
就涉及 AD 诊断范围、试验对象选择、结局指标和分析方法的关键原则达成了普遍共识。
已经达成共识,支持在早期(痴呆前)AD 人群中测试候选治疗方法。