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Journal of Alzheimer's disease : JAD
2024;101 (1): 1-12.

A Framework for Best Practices and Readiness in the Advent of Anti-Amyloid Therapy for Early Alzheimer's Disease in Asia.

Jae-Hong Lee, Jianping Jia, Yong Ji, Nagaendran Kandiah, SangYun Kim, Vincent Mok, Ming-Chyi Pai, Vorapun Senanarong, Chong Hyun Suh, Christopher Chen
Author Information
  1. Jae-Hong Lee: Department of Neurology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea.
  2. Jianping Jia: Innovation Center for Neurological Disorders and Department of Neurology, Xuanwu Hospital, Capital Medical University Beijing, China.
  3. Yong Ji: Department of Neurology, Tianjin Huanhu Hospital, Tianjin Key Laboratory of Cerebrovascular and Neurodegenerative Diseases, Tianjin Dementia Institute, Tianjin, China.
  4. Nagaendran Kandiah: Dementia Research Centre (Singapore), Lee Kong Chian School of Medicine, Nanyang Technological University School of Medicine, Singapore.
  5. SangYun Kim: Department of Neurology, Seoul National University Bundang Hospital and Seoul National University College of Medicine, Seoul, South Korea.
  6. Vincent Mok: Lau Tat Chuen Research Centre of Brain Degenerative Diseases in Chinese, Division of Neurology, Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Hong Kong SAR, China.
  7. Ming-Chyi Pai: Department of Neurology, Division of Behavioral Neurology, College of Medicine and Hospital, National Cheng Kung University, Tainan, Taiwan.
  8. Vorapun Senanarong: Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand.
  9. Chong Hyun Suh: Department of Neurology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea.
  10. Christopher Chen: Department of Pharmacology, Memory Aging and Cognition Centre, Yong Loo Lin School of Medicine, National University of Singapore, Singapore.
PMID: 39058448 DOI: 10.3233/JAD-240684

Abstract

Advances in biomarker-based diagnostic modalities, recent approval of anti-amyloid monoclonal antibodies for early Alzheimer's disease (AD; mild cognitive impairment or mild dementia due to AD) and late-stage clinical development of other disease-modifying therapies for AD necessitate a significant paradigm shift in the early detection, diagnosis and management of AD. Anti-amyloid monoclonal antibodies target the underlying pathophysiological mechanisms of AD and have demonstrated a significant reduction in the rate of clinical decline in cognitive and functional outcome measures in patients with early AD. With growing recognition of the benefit of early interventions in AD, an increasing number of people may seek diagnosis for their subjective cognitive problems in an already busy medical system. Various factors such as limited examination time, lack of expertise for cognitive assessment and limited access to specialized tests can impact diagnostic accuracy and timely detection of AD. To overcome these challenges, a new model of care will be required. In this paper, we provide practical guidance for institutional readiness for anti-amyloid therapies for early AD in Asia, in terms of best practices for identifying eligible patients and diagnosing them appropriately, safe administration of anti-amyloid monoclonal antibodies and monitoring of treatment, managing potential adverse events such as infusion reactions and amyloid-related imaging abnormalities, and cross-disciplinary collaboration. Education and training will be the cornerstone for the establishment of new pathways of care for the identification of patients with early AD and delivery of anti-amyloid therapies in a safe and efficient manner to eligible patients.

Keywords

Alzheimer’s disease Asia amyloid-β best practice mild cognitive impairment

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MeSH Term

Humans
Alzheimer Disease
Asia
Antibodies, Monoclonal
Early Diagnosis
Amyloid beta-Peptides

Chemicals

Antibodies, Monoclonal
Amyloid beta-Peptides
Journal Article Review

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