bottlenecksBottleneck

Trial populations that skip mixed disease

Antibody trials largely enrolled people with biomarker-supported Alzheimer’s disease and excluded much mixed, vascular, and diverse disease.

When a person has mixed pathology, atrial fibrillation, or anticoagulation, the trial result may not apply. Inclusive protocols are a proposed fix, not current practice everywhere.

majortrials1 ideas to fix it

Scale of the problem

ENGAGE primary endpoint not met

Failure example on this atlas

ClinicalTrials.gov NCT02477800

Root causes

Strict amyloid and MRI criteria.
Under-enrolment of minoritised groups.
Exclusion of common comorbidities.

Current efforts

Broader phase 4 and registry follow-up after approval.

Success criteria

Label-relevant evidence includes the people who actually present to clinic.

Ideas to fix it

1top

speculativeresearchlarge cost

Antibody trials that enrol mixed and comorbid disease

Test amyloid antibodies in the mixed, comorbid people clinics actually see, instead of only in tidy trial cohorts.

Connected

3top

Term
Mixed dementia
Shares Mixed dementia and the tag dementia-atlas.
Bottleneck
Wrong-subtype treatment
Shares Mixed dementia, Alzheimer’s disease and the tag dementia-atlas.
Person
Alois Alzheimer
Shares Alzheimer’s disease and the tag dementia-atlas.
Treatment
Brexpiprazole
Shares Alzheimer’s disease and the tag dementia-atlas.
Collection
ClinicalTrials.gov
Shares Alzheimer’s disease and the tag dementia-atlas.
Treatment
Memantine
Shares Alzheimer’s disease and the tag dementia-atlas.
Institution
National Institute on Aging
Shares Alzheimer’s disease and the tag dementia-atlas.
Technology
CSF amyloid and tau
Shares Alzheimer’s disease and the tag dementia-atlas.

diagnoses

Alzheimer’s disease Mixed dementia

ideas