Skip to main content Accessibility help

We use cookies to distinguish you from other users and to provide you with a better experience on our websites. Close this message to accept cookies or find out how to manage your cookie settings.

Close cookie message
×
Hostname: page-component-cd9895bd7-gvvz8 Total loading time: 0 Render date: 2024-12-25T00:54:17.015Z Has data issue: false hasContentIssue false

23 - Globalization of Alzheimer’s Disease Clinical Trials

from Section 3 - Alzheimer’s Disease Clinical Trials

Published online by Cambridge University Press:  03 March 2022

By
Huali Wang ,
Tao Wang ,
Shifu Xiao  and
Xin Yu
Edited by
Jeffrey Cummings ,
Jefferson Kinney  and
Howard Fillit
Jeffrey Cummings
Affiliation:
University of Nevada, Las Vegas
Jefferson Kinney
Affiliation:
University of Nevada, Las Vegas
Howard Fillit
Affiliation:
Alzheimer’s Drug Discovery Foundation
Get access

Summary

Globalization in clinical trials for Alzheimer’s disease (AD) drug development has increased rapidly. It would substantially support persons with dementia to access novel therapeutics in a coordinated and efficient manner. In this chapter, we overview the significant drives of globalization in AD drug development: the growth of the world’s AD population, the need for a larger sample in trials to secure enrollment in the required timeframe, and the ethnographic and ethnobiological contributors. We also discuss the major issues relevant to global trials: the geographic variation across trial sites, the differences in study participants, and the lack of harmonized global regulatory mechanisms. In the end, this chapter recommends that improving site performance, enhancing infrastructure development, and promoting universal regulatory mechanism should be prioritized to maximize the contribution of globalization to the AD drug development ecosystem.

Keywords

globalizationgeographic variationethnographyethnobiologyregulatory mechanisminnovation
Type
Chapter
Information
Alzheimer's Disease Drug Development
Research and Development Ecosystem
 , pp. 275 - 280
Publisher: Cambridge University Press
Print publication year: 2022

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Wimo, A. The worldwide costs of dementia 2015 and comparisons with 2010. Alzheimers Dement 2017; 13: 1–7.CrossRefGoogle ScholarPubMed
Gustavsson, A, Green, C, Jones, RW, et al. Current issues and future research priorities for health economic modelling across the full continuum of Alzheimer’s disease. Alzheimers Dement 2017; 13: 312–21.Google Scholar
Prince, M, Ali, G, Guerchet, M, et al. Recent global trends in the prevalence and incidence of dementia, and survival with dementia. Alzheimers Res Ther 2016; 8: 23.CrossRefGoogle ScholarPubMed
Thiers, FA, Sinskey, AJ, Berndt, ER. Trends in the globalization of clinical trials. Nat Rev Drug Discov 2008; 7: 13–14.CrossRefGoogle Scholar
Cummings, J, Lee, G, Ritter, A, Sabbagh, M, Zhong, K. Alzheimer’s disease drug-development pipeline: 2020. Alzheimers Dement (N Y) 2020; 6: e12050.CrossRefGoogle ScholarPubMed
Nichols, E, Szoeke, CEI, Vollset, SE, et al. Global, regional, and national burden of Alzheimer’s disease and other dementias, 1990–2016: a systematic analysis for the Global Burden of Disease Study 2016. Lancet Neurol 2019; 18: 88–106.Google Scholar
Qiao, Y, Alexander, GC, Moore, TJ. Globalization of clinical trials: variation in estimated regional costs of pivotal trials, 2015–2016. Clin Trials 2019; 16: 329–33.CrossRefGoogle ScholarPubMed
Alzheimer’s Disease International. Dementia statistics. Available at: www.alzint.org/about/dementia-facts-figures/dementia-statistics/ (accessed June 29, 2021).Google Scholar
Jia, L, Du, Y, Chu, L, et al. Prevalence, risk factors, and management of dementia and mild cognitive impairment in adults aged 60 years or older in China: a cross-sectional study. Lancet Public Health 2020; 5: e661–71.Google Scholar
Jia, L, Quan, M, Fu, Y, et al. Dementia in China: epidemiology, clinical management, and research advances. Lancet Neurol 2019; 4422: 1–12.Google Scholar
Jones, CW, Handler, L, Crowell, KE, et al. Non-publication of large randomized clinical trials: cross sectional analysis. BMJ 2013; 347: 1–9.Google Scholar
Gauthier, S, Albert, M, Fox, N, et al. Why has therapy development for dementia failed in the last two decades? Alzheimers Dement 2016; 12: 60–4.CrossRefGoogle ScholarPubMed
Goldman, DP, Fillit, H, Neumann, P. Accelerating Alzheimer’s disease drug innovations from the research pipeline to patients. Alzheimers Dement 2018; 14: 833–6.Google Scholar
Jia, J, Zuo, X, Jia, XF, et al. Diagnosis and treatment of dementia in neurology outpatient departments of general hospitals in China. Alzheimers Dement 2016; 12: 446–53.CrossRefGoogle ScholarPubMed
Wang, H, Xie, H, Qu, Q, et al. The continuum of care for dementia: needs, resources and practice in China. J Glob Health 2019; 9: 020321.CrossRefGoogle ScholarPubMed
Long, JM, Holtzman, DM. Alzheimer disease: an update on pathobiology and treatment strategies. Cell 2019; 179: 312–39.Google Scholar
Wang, X, Wang, H, Li, H, Li, T, Yu, X. Frequency of the apolipoprotein E ε4 allele in a memory clinic cohort in Beijing: a naturalistic descriptive study. PLoS One 2014; 9: e99130.CrossRefGoogle Scholar
Zhang, M, Wang, H, Li, T, Yu, X. Prevalence of neuropsychiatric symptoms across the declining memory continuum: an observational study in a memory clinic setting. Dement Geriatr Cogn Dis Extra 2012; 2: 200–8.CrossRefGoogle Scholar
Petersen, RC, Thomas, RG, Aisen, PS, et al. Randomized controlled trials in mild cognitive impairment: sources of variability. Neurology 2017; 88: 1751–8.CrossRefGoogle ScholarPubMed
Zhao, M, Lv, X, Tuerxun, M, et al. Delayed help seeking behavior in dementia care: preliminary findings from the Clinical Pathway for Alzheimer’s Disease in China (CPAD) study. Int Psychogeriatr 2016; 28: 211–19.Google Scholar
Paulino Ramirez, Diaz S, Gil Gregório, P, Manuel Ribera Casado, J, et al. The need for a consensus in the use of assessment tools for Alzheimer’s disease: the Feasibility Study (assessment tools for dementia in Alzheimer centres across Europe), a European Alzheimer’s Disease Consortium’s (EADC) survey. Int J Geriatr Psychiatry 2005; 20: 744–8.Google Scholar
Shen, JHQ, Shen, Q, Yu, H, et al. Validation of an Alzheimer’s disease assessment battery in Asian participants with mild to moderate Alzheimer’s disease. Am J Neurodegener Dis 2014; 3: 158–69.Google Scholar
Pocock, S, Calvo, G, Marrugat, J, et al. International differences in treatment effect: do they really exist and why? Eur Heart J 2013; 34: 1846–52.Google Scholar
Mentz, RJ, Kaski, J-C, Dan, G-A, et al. Implications of geographical variation on clinical outcomes of cardiovascular trials. Am Heart J 2012; 164: 303–12.Google Scholar
Kristensen, SL, Martinez, F, Jhund, PS, et al. Geographic variations in the PARADIGM-HF heart failure trial. Eur Heart J 2016; 37: 3167–74.Google Scholar
Cummings, JL, Atri, A, Ballard, C, et al. Insights into globalization: comparison of patient characteristics and disease progression among geographic regions in a multinational Alzheimer’s disease clinical program. Alzheimers Res Ther 2018; 10: 116.CrossRefGoogle Scholar
Cummings, J, Reynders, R, Zhong, K. Globalization of Alzheimer’s disease clinical trials. Alzheimers Res Ther 2011; 3: 24.Google Scholar
Wang, H. Nexus between cognitive reserve and modifiable risk factors of dementia. Int Psychogeriatr 2020; 32: 559–62.CrossRefGoogle Scholar
Wang, J, Gu, Y, Dong, W, et al. Lower small-worldness of intrinsic brain networks facilitates the cognitive protection of intellectual engagement in elderly people without dementia: a near-infrared spectroscopy study. Am J Geriatr Psychiatry 2020; 28: 722–31.CrossRefGoogle ScholarPubMed
Henley, DB, Dowsett, SA, Chen, YF, et al. Alzheimer’s disease progression by geographical region in a clinical trial setting. Alzheimers Res Ther 2015; 7: 43.CrossRefGoogle Scholar
Jack, CR, Bennett, DA, Blennow, K, et al. NIA–AA Research Framework: toward a biological definition of Alzheimer’s disease. Alzheimers Dement 2018; 14: 535–62.CrossRefGoogle Scholar
Hampel, H, Vergallo, A, Flores Aguilar, L, et al. Precision pharmacology for Alzheimer’s disease for the Alzheimer Precision Medicine Initiative (APMI). Pharmacol Res 2018; 130: 331–65.CrossRefGoogle Scholar
Wang, X, Sun, G, Feng, T, et al. Sodium oligomannate therapeutically remodels gut microbiota and suppresses gut bacterial amino acids shaped neuroinflammation to inhibit Alzheimer’s disease progression. Cell Res 2019; 29: 787–803.CrossRefGoogle ScholarPubMed
Xiao, S, Chan, P, Wang, T, et al. A 36-week multicenter, randomized, double-blind, placebo-controlled, parallel-group, Phase 3 clinical trial of sodium oligomannate for mild-to-moderate Alzheimer’s dementia. Alzheimers Res Ther 2021; 13: 62.Google Scholar
Editorial. Alzheimer’s disease research enterprise in the era of COVID-19/SARS-CoV-2. Alzheimers Dement 2020; 16: 587–8.Google Scholar

Save book to Kindle

To save this book to your Kindle, first ensure no-reply@cambridge.org is added to your Approved Personal Document E-mail List under your Personal Document Settings on the Manage Your Content and Devices page of your Amazon account. Then enter the ‘name’ part of your Kindle email address below. Find out more about saving to your Kindle.

Note you can select to save to either the @free.kindle.com or @kindle.com variations. ‘@free.kindle.com’ emails are free but can only be saved to your device when it is connected to wi-fi. ‘@kindle.com’ emails can be delivered even when you are not connected to wi-fi, but note that service fees apply.

Find out more about the Kindle Personal Document Service.

Available formats
×

Save book to Dropbox

To save content items to your account, please confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account. Find out more about saving content to Dropbox.

Available formats
×

Save book to Google Drive

To save content items to your account, please confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account. Find out more about saving content to Google Drive.

Available formats
×