期刊
DEMENTIA AND GERIATRIC COGNITIVE DISORDERS
卷 44, 期 3-4, 页码 129-143出版社
KARGER
DOI: 10.1159/000478007
关键词
Alzheimer disease; Amyloid; Diagnosis; Differential diagnosis; Florbetapir
资金
- Eli Lilly and Company
- Avid
- Alzheimer Forum
- ASSM
- Avid/Lilly
- Biogen
- GE International
- Guerbet
- IFRAD Suisse
- Ixico
- Merz
- Nestle
- Novartis
- Piramal
- Roche
- Siemens
- Teva Pharma
- Vifor Pharma
- Alzheimer's Association
- Lilly
- Merck
- Genentech
- Functional Neuromodulation
Aims: To evaluate the impact of amyloid PET imaging on diagnosis and patient management in a multicenter, randomized, controlled study. Methods: Physicians identified patients seeking a diagnosis for mild cognitive impairment or dementia, possibly due to Alzheimer disease (AD), and recorded a working diagnosis and a management plan. The patients underwent florbetapir PET scanning and were randomized to either immediate or delayed (1-year) feedback regarding amyloid status. At the 3-month visit, the physician updated the diagnosis and recorded a summary of the actual patient management since the post-scan visit. The study examined the impact of immediate versus delayed feedback on patient diagnosis/management at 3 and 12 months. Results: A total of 618 subjects were randomized (1: 1) to immediate or delayed feedback arms, and 602 subjects completed the 3-month primary endpoint visit. A higher proportion of patients in the immediate feedback arm showed a change in diagnosis compared to the controls (32.6 vs. 6.4%; p = 0.0001). Similarly, a higher proportion of patients receiving immediate feedback had a change in management plan (68 vs. 55.5%; p < 0.002), mainly driven by changes in AD medication. Specifically, acetylcholinesterase inhibitors were prescribed to 67% of the amyloid-positive and 27% of the amyloid-negative subjects in the information group compared with 56 and 43%, respectively, in the control group (p < 0.0001). These between-group differences persisted until the 12-month visit. Conclusion: Knowledge of the amyloid status affects the diagnosis and alters patient management. (C) 2017 The Author(s) Published by S. Karger AG, Basel
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