Clinical Progression on CDR-SB © : Progression Free Time at Each 0.5-unit Level in Dominantly Inherited and Sporadic Alzheimer’s Disease Populations

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Abstract

INTRODUCTION

CDR-SB is a reliable and clinically meaningful composite for assessing treatment effects in Alzheimer’s disease (AD) clinical trials. Small CDR-SB differences at the end of a trial often lead to controversy in deriving clinically meaningful interpretations.

METHODS

We estimated progression-free time participants remained at each 0.5-unit CDR-SB increment in dominantly inherited AD (DIAD) and sporadic AD populations, evaluating its potential as an alternative measure of treatment effects.

RESULTS

Progression-free time is longer at CDR-SB ≤ 2.0 (1–2 years) and shorter at CDR-SB ≥ 5 (0.33 or less) in the ADNI cohort. The DIAD cohort showed similar but shorter times. Using progression-free time, continuous lecanemab treatment for three years is estimated to delay disease progression by 0.7 years in the sporadic population.

DISCUSSION

Progression-free time provides a benchmark for expressing clinical progression and treatment effects and can be applied particularly during open-label extensions and singlearm trials without placebo comparisons.

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