Alette M Wessels, Eli Lilly and Company, Indianapolis, IN, USA, E-mail:
J Prev Alzheimers Dis. 2023;10(3):595-599. doi: 10.14283/jpad.2023.50.
In Alzheimer's disease (AD) clinical trials, disease-modifying therapies are expected to slow the rate of disease progression. Treatment effects are evaluated using a validated clinical scale as the difference between treatment and placebo in mean change from baseline to endpoint. Understanding the clinical relevance of this metric is not necessarily intuitive. Expressing active treatment-placebo difference as a time metric (i.e., months saved with treatment) has potential to provide a metric that is more easily and consistently interpreted. Using data from the TRAILBLAZER-ALZ study, time component tests (TCTs) were employed to determine the time saved with donanemab (an amyloid lowering drug) treatment. At study endpoint (Week 76), disease progression was delayed by 5.3 months and 5.2 months as measured by the Integrated Alzheimer's Disease Rating Scale (iADRS) and the Clinical Dementia Rating Sum of Boxes (CDR-SB), respectively.
在阿尔茨海默病(AD)临床试验中,人们期望疾病修饰疗法能够减缓疾病进展速度。使用经过验证的临床量表来评估治疗效果,该量表将治疗组与安慰剂组从基线到终点的平均变化差异作为治疗效果的评估指标。然而,这种指标的临床相关性并不直观。将积极治疗与安慰剂的差异表示为时间指标(即治疗可节省的时间),可能提供一种更容易且更一致的解释方式。使用 TRAILBLAZER-ALZ 研究的数据,采用时间成分测试(TCT)来确定使用 donanemab(一种降低淀粉样蛋白的药物)治疗可节省的时间。在研究终点(第 76 周),使用综合阿尔茨海默病评定量表(iADRS)和临床痴呆评定量表总和评分(CDR-SB)分别测量到疾病进展延缓了 5.3 个月和 5.2 个月。