[Significance and progress of DIAN/A4/API].

The DIAN observational study compared the pathophysiological markers between mutation carriers and non-carriers for autosomal dominant Alzheimer's disease. It has revealed the biomarker changes in the mutation carrier's brain started as early as 20, even 25 years prior to symptoms. The researchers of DIAN started the prevention trial(DIAN-TU) with two monoclonal antibodies. The API study is the clinical trial of the anti-amyloid monoclonal antibody therapy to the kindred of early onset familial AD (EOAD) who carry the PSEN1 E280A mutation. This study has also shown the same biomarker changes that were reported in the DIAN study. Anti-Amyloid Treatment in Asymptomatic AD (A4) is a prevention trial aimed at treating cognitive normal older individuals at risk of developing Alzheimer's disease dementia on the basis of having biomarker evidence of amyloid (pre-clinical AD). Solanezumab was selected for the anti-amyloid treatment for A4.