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Conversionfrom mcitoad

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Unformatted text preview: SEASE-MODIFYING STRATEGIES DISEASE-MODIFYING STUDY DESIGNS STUDY Parallel groups with survival to a clinically meaningful endpoint (ex. conversion from MCI to AD). Addition of novel treatment or placebo to ‘standard care’. © TND 2005 Percent without AD diagnosis Hypothetical MCI Trial with Delay to AD Hypothetical as Primary Endpoint as 100 Symptomatic or Disease Modifying Agent 50 Placebo 0 Time in Months 36 © TND 2005 Add-On Design Performance Cholinesterase Inhibitor & Cholinesterase Disease Modifying Agent Disease Stable Dose of Cholinesterase Cholinesterase Inhibitor Inhibitor Cholinesterase Inhibitor & Cholinesterase Placebo Placebo -3 0 12 Time © TND 2005 DISEASE MODIFYING STRATEGIES DISEASE FOR AD: TREATMENT OPTIONS FOR Control of vascular risk factors Anti­inflammatory drugs Post­menopausal hormonal therapy Inhibition of beta secretase Immunotherapy (“vaccine”) Inhibition of fibrillogenesis Anti­oxidants Statins © TND 2005 CONCLUSIONS CI offer useful benefit in AD and mixed AD/VaD. Treatment expectations should be a stabilization of decline of cognition, functional autonomy and behavior over time. Switching between CI is possible. Future improvements will be in modifying disease progression. © TND 2005...
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