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A Precision Medicine Model for Targeted NSAID Therapy in Alzheimer's Disease.
- Source :
-
Journal of Alzheimer's disease : JAD [J Alzheimers Dis] 2018; Vol. 66 (1), pp. 97-104. - Publication Year :
- 2018
-
Abstract
- Background: To date, the therapeutic paradigm for Alzheimer's disease (AD) has focused on a single intervention for all patients. However, a large literature in oncology supports the therapeutic benefits of a precision medicine approach to therapy. Here we test a precision-medicine approach to AD therapy.<br />Objective: To determine if a baseline, blood-based proteomic companion diagnostic predicts response to NSAID therapy.<br />Methods: Proteomic assays of plasma from a multicenter, randomized, double-blind, placebo-controlled, parallel group trial, with 1-year exposure to rofecoxib (25 mg once daily), naproxen (220 mg twice-daily) or placebo.<br />Results: 474 participants with mild-to-moderate AD were screened with 351 enrolled into the trial. Using support vector machine (SVM) analyses, 89% of the subjects randomized to either NSAID treatment arms were correctly classified using a general NSAID companion diagnostic. Drug-specific companion diagnostics yielded 98% theragnostic accuracy in the rofecoxib arm and 97% accuracy in the naproxen arm.<br />Conclusion: Inflammatory-based companion diagnostics have significant potential to identify select patients with AD who have a high likelihood of responding to NSAID therapy. This work provides empirical support for a precision medicine model approach to treating AD.
Details
- Language :
- English
- ISSN :
- 1875-8908
- Volume :
- 66
- Issue :
- 1
- Database :
- MEDLINE
- Journal :
- Journal of Alzheimer's disease : JAD
- Publication Type :
- Academic Journal
- Accession number :
- 30198872
- Full Text :
- https://doi.org/10.3233/JAD-180619