Platform Trials to Expedite Drug Development in Alzheimer's Disease: A Report from the EU/US CTAD Task Force.

A diverse range of platforms has been established to increase the efficiency and speed of clinical trials for Alzheimer's disease (AD). These platforms enable parallel assessment of multiple therapeutics, treatment regimens, or participant groups; use uniform protocols and outcome measures; and may allow treatment arms to be added or dropped based on interim analyses of outcomes. The EU/US CTAD Task Force discussed the lessons learned from the Dominantly Inherited Alzheimer's Network Trials Unit (DIAN-TU) platform trial and the challenges addressed by other platform trials that have launched or are in the planning stages. The landscape of clinical trial platforms in the AD space includes those testing experimental therapies such as DIAN-TU, platforms designed to test multidomain interventions, and those designed to streamline trial recruitment by building trial-ready cohorts. The heterogeneity of the AD patient population, AD drugs, treatment regimens, and analytical methods complicates the design and execution of platform trials, yet Task Force members concluded that platform trials are essential to advance the search for effective AD treatments, including combination therapies.
Competing Interests: The Task Force was partially funded by registration fees from industrial participants. These corporations placed no restrictions on this work. Dr. Aisen reports grants from Janssen, NIA, FNIH, Alzheimer’s Association, and Eisai, personal fees from Merk, Biogen, Roche, ImmunoBrain Checkpoint, Abbvie, Rainbow Medical, and personal fees from Shionogi, outside the submitted work. Dr. Bateman reports grants from the Alzheimers Association, NIH, FNIH, GHR Foundation, Eli Lilly and Company, Hoffman-LaRoche, Avid Radiopharmaceuticals, Janssen, Eisai, Genetech Abbvie, Biogen, Centene, United Neuroscience, and an anonymous organization. In-kind support from CogState and Signant. Personal fees from Hoffman-LaRoche, Janssen, Eisai, C2N Diagnostics, AC Immune, Amgen, and Pfizer. Dr. Carrillo does not have any COI and is a full time empolyee of the Alzheimer’s Assn. Dr. Doody is a full-time employee of F. Hoffman LaRoche/Genentech; Dr. Johnson reports personal fees from Novartis, AC Immune, Janssen and Cerveau, outside the submitted work. Dr. Sims is an empolyee of Lilly. Dr. Sperling reports grants from Eli Lilly, NIA, Alzheimer’s Association, Janssen, Eisai, personal fees from Shionogi, Genentech, Oligomerix, Inc., Cytox, Prothena, Acumen, JOMDD, Renew, Alnylam Pharmaceuticals, Neuraly, Janssen, Neurocentria, AC Immune, Biogen, Eisai, Roche and Takeda Pharmaceuticals, outside the submitted work. Dr. Vellas reports grants from Lilly, Merck, Roche, Lundbeck, Biogen, grants from Alzheimer’s Association, European Commission, personal fees from Lilly, Merck, Roche, Biogen, outside the submitted work.