Early Diagnosis and Treatment in Alzheimer's Disease

Michael S. Rafii, MD, PhD


June 01, 2023

Innovations allowing for early diagnosis of Alzheimer’s disease (AD) and the development of disease-modifying therapies for AD are converging to create what Dr Michael Rafii says could be a breakthrough in efforts to modify the course of this condition.

Most patients are diagnosed in the middle-to-late stages of AD, by which time irreversible neurodegeneration has taken place. Earlier diagnosis has been elusive. Cerebrospinal fluid tests are invasive and positron emission technology can detect Alzheimer’s pathology but is expensive and generally not covered by insurance. But recently developed blood biomarker tests have shown efficacy and could allow for earlier detection, which could change the AD landscape, according to Dr Rafii

Concurrently, several therapies targeting amyloid beta have shown promise in late-phase clinical trials. In one phase 3 trial, the anti-amyloid monoclonal antibody donanemab demonstrated a 35% slowing of cognitive decline and 72% of patients achieved plaque clearance by 18 months.

Dr Rafii cautions that there is much yet to learn about the efficacy and safety of these new therapies but underscores progress has been made in understanding and treating this challenging disease.


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