The importance of endpoint selection: how effective does a drug need to be for success in a clinical trial of a possible Alzheimer's disease treatment?
File(s)Evans2018_Article_TheImportanceOfEndpointSelecti.pdf (1.03 MB)
Published version
Author(s)
Type
Journal Article
Abstract
To date, Alzheimer's disease (AD) clinical trials have been largely unsuccessful. Failures have been attributed to a number of factors including ineffective drugs, inadequate targets, and poor trial design, of which the choice of endpoint is crucial. Using data from the Alzheimer's Disease Neuroimaging Initiative, we have calculated the minimum detectable effect size (MDES) in change from baseline of a range of measures over time, and in different diagnostic groups along the AD development trajectory. The Functional Activities Questionnaire score had the smallest MDES for a single endpoint where an effect of 27% could be detected within 3 years in participants with Late Mild Cognitive Impairment (LMCI) at baseline, closely followed by the Clinical Dementia Rating Sum of Boxes (CDRSB) score at 28% after 2 years in the same group. Composite measures were even more successful than single endpoints with an MDES of 21% in 3 years. Using alternative cognitive, imaging, functional, or composite endpoints, and recruiting patients that have LMCI could improve the success rate of AD clinical trials.
Date Issued
2018-07-01
Date Acceptance
2018-03-16
Citation
European Journal of Epidemiology, 33 (7), pp.635-644
ISSN
0393-2990
Publisher
Springer Verlag
Start Page
635
End Page
644
Journal / Book Title
European Journal of Epidemiology
Volume
33
Issue
7
Copyright Statement
© The Author(s) 2018. This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made.
Identifier
https://www.ncbi.nlm.nih.gov/pubmed/29572656
PII: 10.1007/s10654-018-0381-0
Subjects
Alzheimer’s disease
Clinical trials
Longitudinal data analysis
Publication Status
Published
Coverage Spatial
Netherlands
Date Publish Online
2018-03-23