ADVISORY COUNCIL ON ALZHEIMER'S RESEARCH, CARE, AND SERVICES
Friday, January 26, 2018
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Research Subcommittee Agenda: The Journey from Targets to Treatments
Brad Hyman and Allan Levey, Co-chairs
National Alzheimer's Project Act (NAPA) and the National Plans to Address Alzheimer's Disease
- Prevent and Effectively Treat Alzheimer's Disease by 2025.
- Optimize Care Quality and Efficiency.
- Expand Supports for People with Alzheimer's Disease and Their Families.
- Enhance Public Awareness and Engagement.
- Track Progress and Drive Improvement.
NIH AD and ADRD Research Summits - Recommendations
- AD 2015
- Interdisciplinary Research to Understand the Heterogeneity and Multifactorial Etiology of Disease
- Transforming AD Therapy Development: From Targets to Trials
- New Strategies for Prevention
- Innovating Disease Monitoring, Assessment and Care
- Empowering Patients, Engaging Citizens
- Enabling Partnerships for Open Innovation
- ADRD 2016
- Multiple Etiology Dementias -- Diagnosing Dementia in the 21st Century
- Non-Governmental Organizations
- AD/ADRD Health Disparities
- Lewy Body Dementias
- Frontotemporal Lobar Degeneration
- Vascular Contributions to Cognitive Impairment and Dementia
The Progression of Alzheimer's Disease and Clinical Trials
|Modified from Jack et al., Lancet Neurol (2009)|
Challenges of developing treatments for AD
- Prevention, disease modifying, and symptomatic treatments may have substantially different therapeutic targets, and certainly require different clinical trial designs
- Disease heterogeneity -- varied rates of progression -- make trials complicated to run with a typical trial having thousands of patients followed for 2 or more years, at a cost of hundreds of millions per trial
- Complicated disease with potentially different "phases" -- may need a "right person, right time, right drug" approach, in analogy to chronic diseases like atherosclerosis or even cancer -- where different therapies are used to prevent illness or treat established disease
- Recent high profile failures lead to caution in new investments