Dr Cummings relays how testing methods influence the treatment course for Alzheimer’s disease.
Jeffrey L. Cummings, MD, ScD: The approval of aducanumab on the basis of amyloid lowering on the PET [positron emission tomography] scan, which was deemed by the FDA to be reasonably likely to predict clinical benefit, has produced new challenges to the care of patients with Alzheimer’s disease and our entire health care system. Patients have to be diagnosed accurately. They have to have the PET scan in order to confirm the diagnosis, or CSF [cerebrospinal fluid] (testing). Most of the new drugs, including aducanumab—the only approved agent—are administered by infusion. One of the drugs, gantenerumab, is administered by subcutaneous injection. MRI has to be done frequently in order to monitor ARIA [amyloid-related imaging abnormalities].
You can see that there’s a huge demand on the health care system. We need excellent diagnosticians, PET scans, infusion centers, and MRI readily available. We’re just beginning to make the adjustments to aducanumab and all the other new drugs that are coming in the pipeline for Alzheimer’s disease. But of course, this is great. We’re making scientific progress. We have new treatments. We should be able to absorb them into a health care system that’s responding to the health needs of our patients.
This transcript has been edited for clarity.