How many patients are eligible for disease-modifying treatment in Alzheimer’s disease? A French national observational study over 5 years
ObjectiveWe aimed to study the epidemiology of the prodromal and mild stages of Alzheimer’s disease (AD) patients who are eligible for clinical trials with disease-modifying therapies.SettingsWe analysed two large complementary databases to study the incidence and characteristics of this population...
| Main Authors: | , , , , , , , , , , , , , , , , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
BMJ Publishing Group
2019-06-01
|
| Series: | BMJ Open |
| Online Access: | https://bmjopen.bmj.com/content/9/6/e029663.full |
| _version_ | 1818355341413318656 |
|---|---|
| author | Didier Hannequin Florence Pasquier Bruno Dubois David Wallon Julien Dumurgier Stéphane Epelbaum Thérèse Jonveaux Annick Besozzi Stéphane Pouponneau Caroline Hommet Laetitia Berly Adrien Julian Marc Paccalin Julie Bellet Claire Boutoleau-Bretonniere Thiphaine Charriau Olivier Rouaud Olivier Madec Aurélie Mouton Renaud David Samir Bekadar Roxane Fabre Walter Deberdt |
| author_facet | Didier Hannequin Florence Pasquier Bruno Dubois David Wallon Julien Dumurgier Stéphane Epelbaum Thérèse Jonveaux Annick Besozzi Stéphane Pouponneau Caroline Hommet Laetitia Berly Adrien Julian Marc Paccalin Julie Bellet Claire Boutoleau-Bretonniere Thiphaine Charriau Olivier Rouaud Olivier Madec Aurélie Mouton Renaud David Samir Bekadar Roxane Fabre Walter Deberdt |
| author_sort | Didier Hannequin |
| collection | DOAJ |
| description | ObjectiveWe aimed to study the epidemiology of the prodromal and mild stages of Alzheimer’s disease (AD) patients who are eligible for clinical trials with disease-modifying therapies.SettingsWe analysed two large complementary databases to study the incidence and characteristics of this population on a nationwide scope in France from 2014 to 2018. The National Alzheimer Database contains data from 357 memory centres and 90 private neurologists. Data from 2014 to 2018 have been analysed.ParticipantsPatients, 50–85 years old, diagnosed with AD who had an Mini-Mental State Exam (MMSE) score of ≥20 were included. We excluded patients with mixed and non-AD neurocognitive disorders.Primary outcome measureDescriptive statistics of the population of interest was the primary measure.ResultsIn the National Alzheimer Database, 550 198 patients were assessed. Among them, 72 174 (13.1%) were diagnosed with AD and had an MMSE ≥20. Using corrections for specificity of clinical diagnosis of AD, we estimated that about 50 000 (9.1%) had a prodromal or mild AD. In the combined electronic clinical records database of 11 French expert memory centres, a diagnosis of prodromal or mild AD, certified by the use of cerebrospinal fluid AD biomarkers, could be established in 195 (1.3%) out of 14 596 patients.ConclusionsAD was not frequently diagnosed at a prodromal or mild dementia stage in France in 2014 to 2018. Diagnosis rarely relied on a pathophysiological marker even in expert memory centres. National databases will be valuable to monitor early stage AD diagnosis efficacy in memory centres when a disease-modifying treatment becomes available. |
| first_indexed | 2024-12-13T19:39:47Z |
| format | Article |
| id | doaj.art-56ea6c9e15a3480ab28e25a9c18588ae |
| institution | Directory Open Access Journal |
| issn | 2044-6055 |
| language | English |
| last_indexed | 2024-12-13T19:39:47Z |
| publishDate | 2019-06-01 |
| publisher | BMJ Publishing Group |
| record_format | Article |
| series | BMJ Open |
| spelling | doaj.art-56ea6c9e15a3480ab28e25a9c18588ae2022-12-21T23:33:44ZengBMJ Publishing GroupBMJ Open2044-60552019-06-019610.1136/bmjopen-2019-029663How many patients are eligible for disease-modifying treatment in Alzheimer’s disease? A French national observational study over 5 yearsDidier Hannequin0Florence Pasquier1Bruno Dubois2David Wallon3Julien Dumurgier4Stéphane Epelbaum5Thérèse Jonveaux6Annick Besozzi7Stéphane Pouponneau8Caroline Hommet9Laetitia Berly10Adrien Julian11Marc Paccalin12Julie Bellet13Claire Boutoleau-Bretonniere14Thiphaine Charriau15Olivier Rouaud16Olivier Madec17Aurélie Mouton18Renaud David19Samir Bekadar20Roxane Fabre21Walter Deberdt227 Department of Neurology, CHU Charles Nicolle, Rouen, France Univ Lille, CHU, Inserm U1172, DISTALZ, LiCEND, Lille, France24 Neurology, CHU de la Pitiè Salpêtrière-AP-HP, Paris, France Normandie Univ, UNIROUEN, Inserm U1245 and Rouen University Hospital, Department of Neurology and CNR-MAJ, Normandy Center for Genomic and Personalized Medicine, Rouen, France4 Cognitive Neurology Center, CMRR Paris-Nord Ile-de-France, Groupe hospitalier Lariboisiere Fernand-Widal, Paris, France 1 Institute of Memoryand Alzheimer’s Disease (IM2A) and Brain and Spine Institute(ICM) UMR S 1127, Inria, Aramis-Project Team, Department of Neurology, AP-HP, Pitié-Salpêtrière University Hospital, Sorbonne Universities, Pierre et Marie Curie University, Paris 06 and National Reference Center for Rare or Early Dementias and Center of Excellence of Neurodegenerative Disease (CoEN), Paris, France8 Gériatrie, CHRU de Nancy, Nancy, France8 Gériatrie, CHRU de Nancy, Nancy, France9 Gériatrie, CHU de Tours, Tours, France9 Gériatrie, CHU de Tours, Tours, France 11 Gériatrie, CHU de Strasbourg, Strasbourg, France12 Gériatrie, CHU de Poitiers, Poitiers, France12 Centre d’Investigation Clinique CIC 1402, INSERM, Centre Hospitalier Universitaire de Poitiers, Poitiers, France 15 Neurology, Centre Hospitalier Regional Universitaire de Lille Pole Neurosciences et Appareil Locomoteur, Lille, France16 CHU Nantes, Nantes, France17 Neurology, CHU de Nantes, Nantes, France18 Neurology, CHU de Dijon, Dijon, France 18 Neurology, CHU de Dijon, Dijon, France19 Department of Neuropsychiatry, CHU de nice, Nice, France20 Centre Mémoire de Ressources et de Recherche, Centre Hospitalier Universitaire de Nice, Nice, France21 Department of Clinical Research, Institut du cerveau et de la moelle epiniere, Paris, France19 Department of Neuropsychiatry, CHU de nice, Nice, France23 Medical Department, Eli Lilly and Co, Indianapolis, Indiana, USAObjectiveWe aimed to study the epidemiology of the prodromal and mild stages of Alzheimer’s disease (AD) patients who are eligible for clinical trials with disease-modifying therapies.SettingsWe analysed two large complementary databases to study the incidence and characteristics of this population on a nationwide scope in France from 2014 to 2018. The National Alzheimer Database contains data from 357 memory centres and 90 private neurologists. Data from 2014 to 2018 have been analysed.ParticipantsPatients, 50–85 years old, diagnosed with AD who had an Mini-Mental State Exam (MMSE) score of ≥20 were included. We excluded patients with mixed and non-AD neurocognitive disorders.Primary outcome measureDescriptive statistics of the population of interest was the primary measure.ResultsIn the National Alzheimer Database, 550 198 patients were assessed. Among them, 72 174 (13.1%) were diagnosed with AD and had an MMSE ≥20. Using corrections for specificity of clinical diagnosis of AD, we estimated that about 50 000 (9.1%) had a prodromal or mild AD. In the combined electronic clinical records database of 11 French expert memory centres, a diagnosis of prodromal or mild AD, certified by the use of cerebrospinal fluid AD biomarkers, could be established in 195 (1.3%) out of 14 596 patients.ConclusionsAD was not frequently diagnosed at a prodromal or mild dementia stage in France in 2014 to 2018. Diagnosis rarely relied on a pathophysiological marker even in expert memory centres. National databases will be valuable to monitor early stage AD diagnosis efficacy in memory centres when a disease-modifying treatment becomes available.https://bmjopen.bmj.com/content/9/6/e029663.full |
| spellingShingle | Didier Hannequin Florence Pasquier Bruno Dubois David Wallon Julien Dumurgier Stéphane Epelbaum Thérèse Jonveaux Annick Besozzi Stéphane Pouponneau Caroline Hommet Laetitia Berly Adrien Julian Marc Paccalin Julie Bellet Claire Boutoleau-Bretonniere Thiphaine Charriau Olivier Rouaud Olivier Madec Aurélie Mouton Renaud David Samir Bekadar Roxane Fabre Walter Deberdt How many patients are eligible for disease-modifying treatment in Alzheimer’s disease? A French national observational study over 5 years BMJ Open |
| title | How many patients are eligible for disease-modifying treatment in Alzheimer’s disease? A French national observational study over 5 years |
| title_full | How many patients are eligible for disease-modifying treatment in Alzheimer’s disease? A French national observational study over 5 years |
| title_fullStr | How many patients are eligible for disease-modifying treatment in Alzheimer’s disease? A French national observational study over 5 years |
| title_full_unstemmed | How many patients are eligible for disease-modifying treatment in Alzheimer’s disease? A French national observational study over 5 years |
| title_short | How many patients are eligible for disease-modifying treatment in Alzheimer’s disease? A French national observational study over 5 years |
| title_sort | how many patients are eligible for disease modifying treatment in alzheimer s disease a french national observational study over 5 years |
| url | https://bmjopen.bmj.com/content/9/6/e029663.full |
| work_keys_str_mv | AT didierhannequin howmanypatientsareeligiblefordiseasemodifyingtreatmentinalzheimersdiseaseafrenchnationalobservationalstudyover5years AT florencepasquier howmanypatientsareeligiblefordiseasemodifyingtreatmentinalzheimersdiseaseafrenchnationalobservationalstudyover5years AT brunodubois howmanypatientsareeligiblefordiseasemodifyingtreatmentinalzheimersdiseaseafrenchnationalobservationalstudyover5years AT davidwallon howmanypatientsareeligiblefordiseasemodifyingtreatmentinalzheimersdiseaseafrenchnationalobservationalstudyover5years AT juliendumurgier howmanypatientsareeligiblefordiseasemodifyingtreatmentinalzheimersdiseaseafrenchnationalobservationalstudyover5years AT stephaneepelbaum howmanypatientsareeligiblefordiseasemodifyingtreatmentinalzheimersdiseaseafrenchnationalobservationalstudyover5years AT theresejonveaux howmanypatientsareeligiblefordiseasemodifyingtreatmentinalzheimersdiseaseafrenchnationalobservationalstudyover5years AT annickbesozzi howmanypatientsareeligiblefordiseasemodifyingtreatmentinalzheimersdiseaseafrenchnationalobservationalstudyover5years AT stephanepouponneau howmanypatientsareeligiblefordiseasemodifyingtreatmentinalzheimersdiseaseafrenchnationalobservationalstudyover5years AT carolinehommet howmanypatientsareeligiblefordiseasemodifyingtreatmentinalzheimersdiseaseafrenchnationalobservationalstudyover5years AT laetitiaberly howmanypatientsareeligiblefordiseasemodifyingtreatmentinalzheimersdiseaseafrenchnationalobservationalstudyover5years AT adrienjulian howmanypatientsareeligiblefordiseasemodifyingtreatmentinalzheimersdiseaseafrenchnationalobservationalstudyover5years AT marcpaccalin howmanypatientsareeligiblefordiseasemodifyingtreatmentinalzheimersdiseaseafrenchnationalobservationalstudyover5years AT juliebellet howmanypatientsareeligiblefordiseasemodifyingtreatmentinalzheimersdiseaseafrenchnationalobservationalstudyover5years AT claireboutoleaubretonniere howmanypatientsareeligiblefordiseasemodifyingtreatmentinalzheimersdiseaseafrenchnationalobservationalstudyover5years AT thiphainecharriau howmanypatientsareeligiblefordiseasemodifyingtreatmentinalzheimersdiseaseafrenchnationalobservationalstudyover5years AT olivierrouaud howmanypatientsareeligiblefordiseasemodifyingtreatmentinalzheimersdiseaseafrenchnationalobservationalstudyover5years AT oliviermadec howmanypatientsareeligiblefordiseasemodifyingtreatmentinalzheimersdiseaseafrenchnationalobservationalstudyover5years AT aureliemouton howmanypatientsareeligiblefordiseasemodifyingtreatmentinalzheimersdiseaseafrenchnationalobservationalstudyover5years AT renauddavid howmanypatientsareeligiblefordiseasemodifyingtreatmentinalzheimersdiseaseafrenchnationalobservationalstudyover5years AT samirbekadar howmanypatientsareeligiblefordiseasemodifyingtreatmentinalzheimersdiseaseafrenchnationalobservationalstudyover5years AT roxanefabre howmanypatientsareeligiblefordiseasemodifyingtreatmentinalzheimersdiseaseafrenchnationalobservationalstudyover5years AT walterdeberdt howmanypatientsareeligiblefordiseasemodifyingtreatmentinalzheimersdiseaseafrenchnationalobservationalstudyover5years |