1. Cerebrospinal Fluid Biomarkers for Alzheimer's Disease
- Author
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Mahesh N. Samtani, Richard Batrla-Utermann, Leslie Carter, Stephen P. Arneric, Janice Hitchcock, Diane Stephenson, Leslie M. Shaw, Tobias Bittner, Hugo Vanderstichele, Brian A. Willis, Robert A. Dean, Robert M. Umek, Mark Forrest Gordon, Kaj Blennow, Sebastiaan Engelborghs, Laurel A. Beckett, Just Genius, Mary J. Savage, Susan Yule, June Kaplow, Klaus Romero, Richard Meibach, David Raunig, Johan Luthman, Clinical sciences, and Neurology
- Subjects
0301 basic medicine ,medicine.medical_specialty ,Review ,Disease ,Approved drug ,Alzheimer Disease/cerebrospinal fluid ,03 medical and health sciences ,0302 clinical medicine ,Alzheimer Disease ,Drug Discovery ,medicine ,Humans ,Regulatory science ,Biomarkers/cerebrospinal fluid ,cerebrospinal fluid biomarkers ,Psychiatry ,Intensive care medicine ,Drug Approval ,Medicine(all) ,Clinical Trials as Topic ,business.industry ,General Neuroscience ,General Medicine ,medicine.disease ,3. Good health ,Data sharing ,Clinical trial ,Psychiatry and Mental health ,Clinical Psychology ,030104 developmental biology ,Drug development ,Biomarker (medicine) ,Human medicine ,Geriatrics and Gerontology ,Alzheimer's disease ,Coalition Against Major Diseases ,business ,Alzheimer’s disease ,biomarker qualification ,Biomarkers ,030217 neurology & neurosurgery - Abstract
Alzheimer’s disease (AD) drug development is burdened with the current requirement to conduct large, lengthy, and costly trials to overcome uncertainty in patient progression and effect size on treatment outcome measures. There is an urgent need for the discovery, development, and implementation of novel, objectively measured biomarkers for AD that would aid selection of the appropriate subpopulation of patients in clinical trials, and presumably, improve the likelihood of successfully evaluating innovative treatment options. Amyloid deposition and tau in the brain, which are most commonly assessed either in cerebrospinal fluid (CSF) or by molecular imaging, are consistently and widely accepted. Nonetheless, a clear gap still exists in the accurate identification of subjects that truly have the hallmarks of AD. The Coalition Against Major Diseases (CAMD), one of 12 consortia of the Critical Path Institute (C-Path), aims to streamline drug development for AD and related dementias by advancing regulatory approved drug development tools for clinical trials through precompetitive data sharing and adoption of consensus clinical data standards. This report focuses on the regulatory process for biomarker qualification, briefly comments on how it contrasts with approval or clearance of companion diagnostics, details the qualifications currently available to the field of AD, and highlights the current challenges facing the landscape of CSF biomarkers qualified as hallmarks of AD. Finally, it recommends actions to accelerate regulatory qualification of CSF biomarkers that would, in turn, improve the efficiency of AD therapeutic development.
- Published
- 2017