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采用整合阿尔茨海默病评定量表的疾病进展模型。

Disease progression model using the integrated Alzheimer's Disease Rating Scale.

机构信息

Eli Lilly and Company, Bracknell, UK.

Eli Lilly and Company, Indianapolis, Indiana, USA.

出版信息

Alzheimers Dement. 2023 Jun;19(6):2253-2264. doi: 10.1002/alz.12876. Epub 2022 Nov 30.

Abstract

INTRODUCTION

An Alzheimer's disease (AD) dementia disease progression model was developed based on the integrated Alzheimer's Disease Rating Scale (iADRS).

METHODS

Data from 3483 placebo participants in six AD trials were used to develop the disease progression model with NONMEM (version 7.4.2) and examined for mild cognitive impairment, and mild and moderate dementia due to AD.

RESULTS

Baseline iADRS score was significantly influenced by AD symptomatic medication use, EXPEDITION2 enrollment (included moderate AD participants), age, and baseline Mini-Mental State Examination (MMSE) score. Rate of disease progression increased across disease stage and was significantly influenced by AD medication use, age, and baseline MMSE score. Apolipoprotein E ε4 carrier status did not influence baseline iADRS score or disease progression.

DISCUSSION

These results demonstrate a disease progression model describing the time course of the iADRS across the AD severity spectrum. This model can assist future clinical trials in study design optimization and treatment effect interpretation.

HIGHLIGHTS

A disease progression model described the integrated Alzheimer's Disease Rating Scale (iADRS) time course in mild cognitive impairment to moderate Alzheimer's disease. Using the linear regression model, iADRS scores can be calculated for Mini-Mental State Examination scores. Results can help optimize future clinical trial design and aid in understanding treatment effects.

摘要

简介

基于综合阿尔茨海默病评定量表(iADRS),建立了阿尔茨海默病(AD)痴呆疾病进展模型。

方法

使用来自六项 AD 试验的 3483 名安慰剂参与者的数据,通过 NONMEM(版本 7.4.2)开发疾病进展模型,并检查轻度认知障碍以及轻度和中度 AD 所致痴呆。

结果

基线 iADRS 评分受 AD 症状性药物使用、EXPEDITION2 入组(包括中度 AD 参与者)、年龄和基线迷你精神状态检查(MMSE)评分显著影响。疾病进展率随疾病阶段而增加,受 AD 药物使用、年龄和基线 MMSE 评分显著影响。载脂蛋白 E ε4 携带状态不影响基线 iADRS 评分或疾病进展。

讨论

这些结果表明,该疾病进展模型描述了 iADRS 在 AD 严重程度谱中的时间过程。该模型可协助未来临床试验的研究设计优化和治疗效果解释。

重点

疾病进展模型描述了从轻度认知障碍到中度阿尔茨海默病的综合阿尔茨海默病评定量表(iADRS)时间过程。使用线性回归模型,可以计算出 MMSE 得分的 iADRS 得分。结果有助于优化未来临床试验设计,并有助于理解治疗效果。

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