Clinical meaningfulness of anti-amyloid therapies in early Alzheimer's disease: Perspectives from the East and Southeast Asia region

초록

Alzheimer's disease (AD) is a neurodegenerative disease characterized by progressive accumulation of toxic amyloid species. The rising prevalence of AD in Asia has made it an increasing public health concern, placing a substantial burden on the economy and healthcare systems. Anti-amyloid therapies (AATs) have demonstrated statistically significant slowing of disease progression at the group level in pivotal trials in early symptomatic AD. We explore the clinical meaningfulness of AATs and considerations impacting on its meaning in East and Southeast Asia. We acknowledge that there is a lack of data on Asian populations, particularly from the perspectives of patients and caregivers, highlighting the need for such evidence to facilitate the successful adoption of AATs in the region. We also propose the conceptual Connect, Align, Reframe, Explain (CARE) communication framework and practical tools to support effective communication with patients and caregivers regarding the benefits of AATs. Highlights Anti-amyloid therapies (AATs) have demonstrated statistically significant group-level effects in slowing of disease progression in early symptomatic Alzheimer's disease. Translating clinical trial outcomes into measures of benefit that are truly meaningful to patients and caregivers is critical for the adoption of AATs. Asia, with its rapidly aging societies, diverse cultural norms and heterogeneous healthcare and reimbursement systems, presents a unique perspective on the clinical meaningfulness of AATs. The proposed Connect, Align, Reframe, Explain (CARE) communication framework concept and practical support tools, such as goal-setting checklist, visual aids and motivational messages, can facilitate effective communication with patients and caregivers regarding the benefit of AATs. Optimizing the full potential of AATs in Asia requires focused efforts on understanding patients' and caregivers' perspectives on treatment benefits, building regional registries to collect real-world data, and aligning care frameworks.

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