Physicians Express Positivity About Alzheimer Disease Progress, Desire for Improved Dementia Testing Practices

Author(s):

A Harris Poll conducted by Quest Diagnostics suggests that more than 65% of US physicians believe the Alzheimer disease field is on the cusp of a breakthrough, with more than 80% noting that earlier evaluation with blood testing may help improve therapeutic approaches.

Michael K. Racke, MD

A new report published by Quest Diagnostics, makers of the QUEST AD-Detect Amyloid-ß_42/40 Ratio test, suggests that 66% of physicians in the United States believe the field has reached a potential turning point in therapeutic development for Alzheimer disease (AD).¹

Notably, although half of the 501 primary care providers (PCPs) surveyed indicated that they do not anticipate a cure for AD being developed—contrasting the 90% of people in the general population that were surveyed—77% expect novel therapies to allow for the transformation of the disease into a manageable one.^1,2 The survey conducted was a Harris Poll, consisting of a pair of online surveys in March 2022. One survey among the licensed PCP population who had a patient load of 2 or more, and another among 2052 Americans aged 18 years and older.¹

In addition to the aforementioned findings, 84% of the PCP cohort reported that early AD risk testing result in earlier and improved disease management, and among the general US population surveyed, 86% believe blood tests for the early detection of AD risk will increasingly become a regular part of preventative care. The report did suggest that cost concerns could impede the adoption of such tests, as 85% of the PCP cohort noted that these tests’ value depends on reimbursement.

Although, 94% of the PCP cohort suggested that blood tests would be more cost effective compared with more invasive methods of detection, such as lumbar punctures or imaging studies.

"We are on the cusp of a new generation of therapies for Alzheimer's disease, but the important role of diagnostics has been missing from the conversation. Patients today are typically screened for Alzheimer's disease only after signs of cognitive impairment emerge and often by expensive methods, such as brain imaging and cerebrospinal fluid taps, which only specialists can perform. As new, efficacious therapies come to the forefront, the need for scalable, less invasive and more cost-effective diagnostics, including in primary care settings, will grow," Michael K. Racke, MD, neurology medical director, Quest Diagnostics, said in a statement.²

Another aspect of this report indicated that Americans desire dementia and AD evaluations earlier than is currently the practice standard—physicians in the report indicated a mean patient age of 66 years at evaluation, while the general population cohort indicated that a mean age of 57 years would be ideal. In total, 83% of the US adult cohort specified a desire to agree to take a blood test if it would help improve treatment. A similar percentage expressed a desire for more education about when such evaluations should occur. Of note, this was the case despite 86% of US adults expressing at least some fear about receiving such a diagnosis.

"Our goal for this report is to help prepare the medical community and engaged patients and caregivers for the transformational healthcare shifts that must occur to unleash the full potential of future treatment and diagnostic innovations to improve outcomes for patients with Alzheimer disease," Racke said.²

Quest’s blood test has been analytically validated in assessing the risk of AD and is designed to be used by a healthcare provider to help assess such risk by evaluating the ratio of Aβ₄₂ and Aβ₄₀ in plasma sourced from a single blood test. As well, Quest noted that it can monitor changes in Aβ42/40 over time to assess the risk potential of progression.

Very recently, another test developed by Fujirebio, called the Lumipulse G ß-Amyloid Ratio (1-42/1-40) test, was awarded marketing by the FDA after being reviewed through the de novo premarket review pathway, a regulatory pathway for low- to moderate-risk devices of a new type.³ The Fujirebio test is similarly intended to measure the ratio of Aß_1-42 and Aß_1-40 concentrations found in human cerebrospinal fluid (CSF) of adults aged 55 years and older, presenting with cognitive impairment who are being evaluated for AD and other causes of cognitive decline.³

"As scientists work to develop treatments for Alzheimer's disease, Quest Diagnostics is also developing laboratory innovations, such as AD-Detect, that have the potential to help physicians more reliably identify patients at risk for the disease, even before symptoms manifest, as well as monitor progression," Chris Scotto DiVetta, vice president and general manager, Neurology and Pharma Services, Quest Diagnostics, said in a statement.² "AD-Detect may also help biopharmaceutical companies seeking better methods of screening patients for participation in trials for AD therapies."

REFERENCES
1. The Coming Alzheimer’s Disease Healthcare Revolution: US Physician and Adult Perspectives on the Future of Diagnostics and Treatment. Quest Diagnostics. May 2022. Accessed May 12, 2022. https://mma.prnewswire.com/media/1807262/Quest_Report.pdf
2. Physicians Foresee an Alzheimer's Disease Treatment Revolution Supported by Advanced Testing Tools, New Quest Diagnostics Report Finds. News release. Quest Diagnostics. May 2, 2022. Accessed May 12, 2022. https://www.prnewswire.com/news-releases/physicians-foresee-an-alzheimers-disease-treatment-revolution-supported-by-advanced-testing-tools-new-quest-diagnostics-report-finds-301536734.html
3. FDA permits marketing for new test to improve diagnosis of Alzheimer’s disease. News release. FDA. May 4, 2022. Accessed May 12, 2022. https://www.fda.gov/news-events/press-announcements/fda-permits-marketing-new-test-improve-diagnosis-alzheimers-disease