Vigneswaran, S;
Vijverberg, EGB;
Barkhof, F;
van de Giessen, E;
Lemstra, AW;
Pijnenburg, Y;
Teunissen, CE;
... van Harten, AC; + view all
(2025)
“Real-world” eligibility for anti-amyloid treatment in a tertiary memory clinic setting.
Alzheimer's and Dementia
, 21
(6)
, Article e70375. 10.1002/alz.70375.
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Abstract
INTRODUCTION: The societal impact of anti-amyloid treatment (AAT) for Alzheimer's disease (AD) depends largely on patient eligibility. Estimates suggest that 1% to 18% of individuals with AD may qualify for AAT; however, data from everyday clinical practice remain limited. This study assessed AAT eligibility in patients at a tertiary memory clinic. METHODS: We included 1309 new patients (63 ± 8 years, 45% women, Mini-Mental State Examination [MMSE] 25 ± 5) who presented to the Alzheimer Center Amsterdam (2020–2022) for standardized diagnostic workup. Eligibility for AAT was based on lecanemab's approved label guidelines. RESULTS: Of 1309 new patients, 514 (39% of new patients) had clinical mild cognitive impairment (MCI) or AD. Of these, 108 (8% new patients/21% clinical MCI/AD) met Clinical Dementia Rating/MMSE criteria, were amyloid positive, and had < 4 microbleeds/superficial siderosis. After further excluding apolipoprotein E ε4/ε4 homozygotes and anticoagulant users, 79 patients (6% new patients/15% clinical MCI/AD) remained eligible. DISCUSSION: Findings indicate limited eligibility for AAT in tertiary memory clinics. Highlights: Initial eligibility for lecanemab was 8% of all patients and 21% of those with clinical mild cognitive impairment (MCI) or Alzheimer's disease (AD) based on approved guidelines in a tertiary memory clinic population. After strict exclusions (such as apolipoprotein E ε4/ε4 homozygosity and anticoagulant use), eligibility dropped to 6% of all patients and 15% of those with clinical MCI or AD. The study highlights the limited real-world applicability of anti-amyloid treatment under current guidelines.
| Type: | Article |
|---|---|
| Title: | “Real-world” eligibility for anti-amyloid treatment in a tertiary memory clinic setting |
| Location: | United States |
| Open access status: | An open access version is available from UCL Discovery |
| DOI: | 10.1002/alz.70375 |
| Publisher version: | https://doi.org/10.1002/alz.70375 |
| Language: | English |
| Additional information: | This work is licensed under a Creative Commons License. The images or other third-party material in this article are included in the Creative Commons license, unless indicated otherwise in the credit line; if the material is not included under the Creative Commons license, users will need to obtain permission from the license holder to reproduce the material. To view a copy of this license, visit http://creativecommons.org/licenses/by/4.0/ |
| Keywords: | Alzheimer's disease, anti‐amyloid treatment, eligibility, real‐world evidence, Humans, Female, Male, Alzheimer Disease, Cognitive Dysfunction, Middle Aged, Aged, Mental Status and Dementia Tests, Eligibility Determination, Tertiary Care Centers |
| UCL classification: | UCL UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Brain Sciences UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Brain Sciences > UCL Queen Square Institute of Neurology |
| URI: | https://discovery.ucl.ac.uk/id/eprint/10211183 |
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