Home > Publications Database > Clinical Effect of Early vs Late Amyloid Positron Emission Tomography in Memory Clinic Patients: The AMYPAD-DPMS Randomized Clinical Trial.
 
Journal Article DZNE-2023-00651
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Clinical Effect of Early vs Late Amyloid Positron Emission Tomography in Memory Clinic Patients: The AMYPAD-DPMS Randomized Clinical Trial.

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2023
American Medical Association Chicago, Ill.

JAMA neurology 80(6), 548 - 557 () [10.1001/jamaneurol.2023.0997]

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

Keyword(s): Humans (MeSH) ; Male (MeSH) ; Female (MeSH) ; Aged (MeSH) ; Alzheimer Disease: psychology (MeSH) ; Brain: metabolism (MeSH) ; Prospective Studies (MeSH) ; Positron-Emission Tomography (MeSH) ; Cognitive Dysfunction (MeSH) ; Amyloid: metabolism (MeSH) ; Amyloidogenic Proteins (MeSH) ; Amyloid beta-Peptides: metabolism (MeSH) ; 3-(3,5-dichlorophenyl)-1-methyl-2,5-pyrrolidinedione ; Amyloid ; Amyloidogenic Proteins ; Amyloid beta-Peptides

Classification:
Contributing Institute(s):
  1. Positron Emissions Tomography (PET) (AG Boecker)
  2. Patient Studies Cologne (AG Jessen)
Research Program(s):
  1. 353 - Clinical and Health Care Research (POF4-353) (POF4-353)

Appears in the scientific report 2023
Database coverage:
Medline ; Creative Commons Attribution CC BY 4.0 ; OpenAccess ; BIOSIS Previews ; Biological Abstracts ; Clarivate Analytics Master Journal List ; Current Contents - Clinical Medicine ; Current Contents - Life Sciences ; Essential Science Indicators ; IF >= 25 ; JCR ; SCOPUS ; Science Citation Index Expanded ; Web of Science Core Collection
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The record appears in these collections:
Document types > Articles > Journal Article
Institute Collections > BN DZNE > BN DZNE-AG Boecker
Institute Collections > BN DZNE > BN DZNE-AG Jessen
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 Record created 2023-06-20, last modified 2023-11-20
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