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Breakthrough Imaging test for the eluse Amyloid Plaque?
By Joel Ross | April 16, 2010
I have been an investigator for AVID Radiopharmaceuticals and participated (and currently participate) in a study where there new imaging agent is being used to detect presence of the very sticky and possibly causative agent in memory loss due to Alzheimer’s Disease called “amyloid”. My readers have read my blogs about amyloid (from the Latin meaning “starch like” or sticky). It is strongly believed by many clinical neuroscientists including yours truly, that the absence of amyloid would be strong evidence against any memory loss to to “impending” or “prodromal Alzheimer’s Disease”. Thus if a scan such as that being used by AVID Radiopharmaceuticals is negative for amyloid, the patient can be fairly reassured Alzheimer’s Disease is unlikely present. However, the mere presence of a positive scan for amyloid does not mean you have Alzheimer’s Disease, but perhaps a pre-Alzheimer’s amyloid state of affairs in your brain. Put another way, having amyloid positive scan cannot be a healthy finding, but not necessarily indicative of Alzheimer’s Disease but it might certainly put you at high risk if more amyloid starts to destroy brain cells. Also, post morten studies have been done and replicated in elderly patients who died without any measurable cognitive impairment (no dementia in life) only to find a good deal of amyloid in the brain post mortem. What does this mean? I believe it suggests some older people can “tolerate” a certain load of the toxic amyloid and never have brain cell death sufficiently severe to cause memory issues. Read below of the very small but exciting news just released yesterday in Toronto.
Positive Interim Results From Phase III Trial Of Amyloid Imaging Agent Florbetapir F18 Presented At American Academy Of Neurology Annual Meeting Article Date: 15 Apr 2010 – 18:00 PDT
Avid Radiopharmaceuticals, Inc. (“Avid”) today announced the presentation of interim data from its landmark florbetapir “Image-to-Autopsy” Phase III study. These data come from the first cohort of subjects in the trial and are the first ever Phase III results for an agent designed to image Alzheimer’s disease pathology. Today, Alzheimer’s disease can only be definitely diagnosed by microscopic detection of beta-amyloid at autopsy. The goal of Avid’s Phase III trial is to test the ability of florbetapir to image beta-amyloid in living patients.
The interim data showed that florbetapir PET imaging results in patients correlated with the levels of beta-amyloid pathology later found in their brains at autopsy. Dr. Adam Fleisher, Associate Director of Brain Imaging at Banner Alzheimer’s Institute, presented the analysis at the 2010 Annual Meeting of the American Academy of Neurology in Toronto, ON.
Dr. Fleisher commented “These preliminary results are very encouraging for the field of amyloid imaging and the future management of Alzheimer’s disease. The data suggest that florbetapir imaging may offer an opportunity to detect amyloid plaques in-life. Knowing if a patient has Alzheimer’s pathology might lead to better patient management — for example, if a patient has memory loss but no amyloid pathology, we could rule-out Alzheimer’s disease, and instead focus on looking for other causes for their symptoms.”
Dr. Fleisher reported the results from the analysis of the first six subjects of the florbetapir “Image-to-Autopsy” Phase III study. The data from this cohort demonstrated that the florbetapir PET images correlated strongly with the post mortem histopathology findings. The PET images not only correctly identified which subjects had beta-amyloid deposits, but also showed where in the brain the deposits had accumulated. The full trial data are expected to be available later this year.
Avid’s florbetapir was the first beta-amyloid imaging compound to enter multi-center, IND clinical studies in the U.S., and has now been studied in more than a dozen trials in over 700 subjects ranging from cognitively normal individuals to those with Alzheimer’s dementia. As well as the pivotal Phase III Image-to-Autopsy study, additional clinical studies in the E.U., South America, Australia and Asia are also being conducted.
About Alzheimer’s Disease and Beta-Amyloid Plaque Deposits
Alzheimer’s disease, a chronic neurodegenerative condition that currently affects over 5 million Americans1, cannot be definitively diagnosed until after death, when a brain autopsy is performed on a patient and evidence of beta-amyloid plaque deposits in the brain – which are a hallmark pathology of the disease – can be found. Accurate diagnosis during life can be challenging, particularly in the early stages of disease, when symptoms are mild and non-definitive and can be mistaken for those of other treatable conditions. Florbetapir, used with positron emission tomography (PET) technology is being assessed for the ability to detect beta-amyloid plaque deposits in-vivo, potentially offering clinically useful diagnostic insight at an early stage.
1 Source: Alzheimer’s Association 2010 Alzheimer’s Disease Facts and Figures
Source
Avid Radiopharmaceuticals, Inc.
Topics: Alzheimer’s Disease, Amyloid Associated Memory Impairment, Uncategorized | 10 Comments »