Clinical Effect of Early vs Late Amyloid Positron Emission Tomography in Memory Clinic Patients
Memory clinic
DOI:
10.1001/jamaneurol.2023.0997
Publication Date:
2023-05-08T15:05:20Z
AUTHORS (328)
ABSTRACT
Amyloid positron emission tomography (PET) allows the direct assessment of amyloid deposition, one main hallmarks Alzheimer disease. However, this technique is currently not widely reimbursed because lack appropriately designed studies demonstrating its clinical effect.To assess effect PET in memory clinic patients.The AMYPAD-DPMS a prospective randomized trial 8 European clinics. Participants were allocated (using minimization method) to 3 study groups based on performance PET: arm 1, early diagnostic workup (within 1 month); 2, late (after mean [SD] [2] months); or 3, if and when managing physician chose. patients with subjective cognitive decline plus (SCD+; SCD features increasing likelihood preclinical disease), mild impairment (MCI), dementia; they assessed at baseline after months. Recruitment took place between April 16, 2018, October 30, 2020. Data analysis was performed from July 2022 January 2023.Amyloid PET.The outcome difference 2 proportion participants receiving an etiological diagnosis very high confidence (ie, ≥90% 50%-100% visual numeric scale) months.A total 844 screened, 840 enrolled (291 271 278 3). Baseline 3-month visit data available for 272 260 (median [IQR] age: 71 [65-77] years; 150/272 male [55%] 135/260 [52%]; 122/272 female [45%] 125/260 [48%]; median education: 12 [10-15] 13 [10-16] years, respectively). After months, 109 (40%) had vs 30 (11%) (P < .001). This consistent across stages (SCD+: 25/84 [30%] 5/78 [6%]; P .001; MCI: 45/108 [42%] 9/102 [9%]; dementia: 39/80 [49%] 16/80 [20%]; .001).In study, allowed receive only months compared who undergone PET. These findings support implementation patients.EudraCT Number: 2017-002527-21.
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