CHICAGO, July 19, 2013 /PRNewswire-USNewswire/ -- A global, collaborative research effort based on public-private partnerships, similar to the projects in the 1950s and 1960s that successfully reduced polio worldwide, will be essential in advancing the prevention, diagnosis, and treatment of Alzheimer's disease, according to two articles written by leaders of the Alzheimer's Association and published in the July 2013 issue of Alzheimer's & Dementia: The Journal of the Alzheimer's Association.
The authors call for the research community to work in partnership to accelerate Alzheimer's and dementia research through funding high-impact research, collaborating with appropriate partners, and convening top experts to answer important research questions, among other tactics.
"A coordinated global research agenda is needed to drive the advances necessary to improve the lives of the millions worldwide with Alzheimer's disease now and to meet the U.S. National Alzheimer's Plan's goal of preventing and effectively treating Alzheimer's disease by 2025," said Maria Carrillo, Ph.D., Alzheimer's Association vice president of Medical and Scientific Relations. "This coordination is essential when considering the limited resources currently allocated to Alzheimer's and dementia research and the magnitude of the impact of the disease in individuals, families and societies."
"The development of tangible interventions for the detection, cure and care of those at-risk or affected with Alzheimer's is our foremost task," Carrillo writes in an editorial. "We must improve the process by which we manage the research enterprise. The field must articulate a unified and integrated vision. The need for new multi-national partnerships is critical."
A third article in the journal presents modifications to guidelines established collaboratively by the Alzheimer's Association and the Society of Nuclear Medicine and Molecular Imaging (SNMMI) for brain amyloid imaging using positron emission tomography (PET) as a tool for Alzheimer's diagnosis.
The modifications were sent to CMS in advance of recent (July 3) draft decision, where the agency agreed to cover one PET scan per person to exclude Alzheimer's in very limited circumstances. The Alzheimer's Association will continue to engage the scientific and healthcare communities, as well as advocates, to educate CMS on behalf of our constituents about the benefits of coverage for brain amyloid imaging -- in limited populations as defined by the scientifically-driven appropriate use criteria -- as CMS develops a final decision.
The Alzheimer's Association and Its Global Public-Private Partnerships
"Leveraging Global Resources to End the Alzheimer's Pandemic," an editorial by Carrillo in the journal, looks back toward past research initiatives and forward toward the organization's current and future public-private research partnerships. Carrillo notes that the publication of the historic "Five-Five, Ten-Ten Plan for Alzheimer's Disease" editorial in 1992 inspired decades of fruitful Alzheimer's research and collaboration among academia, industry, government, and patient-family advocacy groups. One of the most significant breakthroughs resulting from this joint effort, she writes, was the development of amyloid imaging, which "holds great promise for research and clinical practice." Another has been the coming together of researchers, clinicians, and regulators to establish new diagnostic criteria and promote the development of early-stage therapies.
Carrillo reviews the Alzheimer's Association's current global public-private partnerships. These include the Worldwide Alzheimer's Disease Neuroimaging Initiative (WW-ADNI), in which investigators from many different nations are extending the work of the original North American ADNI in investigating new imaging techniques and biomarkers for Alzheimer's disease; the Alzheimer's Association International Conference(AAIC), which gives investigators from around the world an opportunity to exchange information and build cooperative networks; and the Alzheimer's Association Research Roundtable (AARR), an international forum for public-private dialogue on forward-looking scientific and policy issues.
"We are especially proud of the fact that the AARR is uniquely positioned as a 'safe space' where representatives of virtually all major pharmaceutical and biotechnology companies can confer freely and frankly with their colleagues from funding and regulatory agencies," said Carrillo. "At the Roundtable, we are able to let down existing barriers and address shared obstacles through mutual recognition of the immense urgency of the issues confronting us."
Carrillo writes that the need to create new multi-national partnerships is "critical," since no single entity or country "has the capability, resources, or knowledge to solve or mitigate the disease." Issues for which the Alzheimer's Association is actively seeking new collaborative partners, she says, include the expansion of "very large genetic, ethnically, and culturally diverse populations" for multi-national studies, and the "crushing need" for new computer analytical methods for ongoing studies.
A Global Review of Alzheimer's Public-Private Partnerships
In the same issue, Heather Snyder, Ph.D., Alzheimer's Association director of Medical and Scientific Operations, reviews global nonprofit public-private partnerships in Alzheimer's disease research ("Alzheimer's disease public-private partnerships: A landscape of the global nonprofit community"). Noting that the prevalence of dementia worldwide is expected to exceed 115 million by 2050, Snyder and colleagues call for global public-private research collaborations similar to those which first came together in the 1950s and 60s to provide the polio vaccine and then between 1988 and 2012 to reduce polio by more than 99 percent worldwide.
Like polio, writes Snyder, Alzheimer's represents a problem "too big for any one entity to address." Her paper represents an initial inventory, to be updated annually, of public-private partnerships of nonprofit organizations invested in Alzheimer's research worldwide.
In the current article, Snyder reviews more than a dozen such partnerships and the organizations that oversee them. Among them is Alzheimer's Australia, which partners with government, care providers, philanthropic organizations, research centers, and industry partners to (1) sponsor research aimed at effecting change in hospital dementia services, clinical guideline development, and appropriate medication management, and (2) construct and maintain a national network of Dementia Collaborative Research Centres, which coordinate research and translate findings into accessible form for policy makers and service providers.
Also highlighted is the Alzheimer's Drug Discovery Foundation (ADDF), which collaborates with scientists, foundations, industry partners, and contract research organization to rapidly accelerate drug discovery by providing seed funding to academic centers and technology companies. Other global research partnerships reviewed by Snyder include the Accelerate Cure/Treatments for Alzheimer's Disease coalition, Alzheimer's Research United Kingdom, BrightFocus Foundation, Critical Path Institute, and the Alzheimer's Association.
"As we update this review in the coming years, I have every confidence that the list will be longer and more reflective of the global research community, and the list of accomplishments more impressive," said Snyder.
Update of Guidelines for PET Amyloid Imaging in Alzheimer's
A third paper in the July 2013 issue of Alzheimer's & Dementia: The Journal of the Alzheimer's Association, "Update on appropriate use criteria for amyloid PET imaging: Dementia experts, mild cognitive impairment, and education," amends previously published appropriate use criteria for amyloid PET imaging as a diagnostic tool for Alzheimer's disease.
The criteria, first published in January 2013, are the product of a collaborative effort between the Alzheimer's Association and SNMMI, which together assembled an Amyloid Imaging Taskforce (AIT) that reviewed scientific literature and developed consensus recommendations for clinical use of PET in diagnosing Alzheimer's. The AIT concluded that amyloid imaging could potentially be helpful in the diagnosis of people with cognitive impairment when considered along with other clinical information, when performed according to standardized protocols by trained staff, and if the presence or absence of amyloid would increase certainty in the diagnosis and alter the treatment plan.
"This update is a refinement based on reviews from the field," said article co-author Dean Hartley, Ph.D., Alzheimer's Association director of Science Initiatives. "Clinicians, after using this technology for some months, had invaluable suggestions, which we have incorporated into the criteria in order to increase the value and cost-effectiveness of this breakthrough technology as a tool for use in diagnosing Alzheimer's."
"The establishment of these criteria is an outstanding example of exactly the kind of collaboration that will be needed in order to better and more quickly diagnose and treat Alzheimer's disease," said Carrillo. "In fact, amyloid imaging is likely to prove even more valuable in the near future, when new diagnostic and therapeutic methods are developed as a result of burgeoning public-private research collaborations."
The update refines the criteria in three areas:
- Dementia Expert and Documentation. Based on responses to the field, the AIT has further refined its definition of a dementia expert: someone who is self-identified as a physician trained and board-certified in neurology, psychiatry, or geriatric medicine, who devotes a substantial portion (at least 25 percent patient contact) of his or her practice to the evaluation and care of adult patients with acquired cognitive impairment or dementia. To ensure appropriate use of amyloid PET and to standardize referrals, the AIT also developed a checklist to assure that patients considered for amyloid PET have completed a standard clinical evaluation and treatment of comorbidities before imaging is ordered.
- Mild Cognitive Impairment (MCI). The updated guidelines specify which patients with MCI may be appropriately referred to amyloid PET: those with documented persistent or progressive unexplained MCI who the dementia expert has concluded would benefit from greater certainty of the underlying pathology and whose clinical management would change as a result of this certainty.
- Education. To ensure appropriate use of amyloid PET, the AIT recommends a number of professional educational activities offered through AA and SNMMI, including national and local meetings, educational materials, and educational outreach sessions at meetings of professional societies.
About the Society of Nuclear Medicine and Molecular Imaging
The Society of Nuclear Medicine and Molecular Imaging (SNMMI) is an international scientific and medical organization dedicated to raising public awareness about nuclear medicine and molecular imaging, a vital element of today's medical practice that adds an additional dimension to diagnosis, changing the way common and devastating diseases are understood and treated and helping provide patients with the best health care possible. SNMMI's more than 19,000 members set the standard for molecular imaging and nuclear medicine practice by creating guidelines, sharing information through journals and meetings and leading advocacy on key issues that affect molecular imaging and therapy research and practice. For more information, visit www.snmmi.org.
About the Alzheimer's Association
The Alzheimer's Association is the world's leading voluntary health organization in Alzheimer care, support and research. Our mission is to eliminate Alzheimer's disease through the advancement of research, to provide and enhance care and support for all affected, and to reduce the risk of dementia through the promotion of brain health. Our vision is a world without Alzheimer's. Visit www.alz.org or call 800-272-3900.
SOURCE Alzheimer's Association