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Article Dans Une Revue Dementia and Geriatric Cognitive Disorders Année : 2024

Effectiveness of Florbetapir PET Imaging in Changing Patient Management

Michael J Pontecorvo
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Andrew Siderowf
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P Murali Doraiswamy
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Giovanni B Frisoni
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Michael Grundman
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Flavio Nobili
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Carl H Sadowsky
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Stephen Salloway
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Anupa K Arora
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Antoine Chevrette
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Walter Deberdt
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Grazia Dell'Agnello
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Matthew Flitter
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Nick Galante
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Mark J Lowrey
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Ming Lu
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Anne Mcgeehan
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Michael D Devous Sr
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Mark A Mintun
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Résumé

Aims: To evaluate the impact of amyloid PET imaging on diagnosis and patient management in a multicenter, randomized, controlled study. Methods: Physicians identified patients seeking a diagnosis for mild cognitive impairment or dementia, possibly due to Alzheimer disease (AD), and recorded a working diagnosis and a management plan. The patients underwent florbetapir PET scanning and were randomized to either immediate or delayed (1-year) feedback regarding amyloid status. At the 3-month visit, the physician updated the diagnosis and recorded a summary of the actual patient management since the post-scan visit. The study examined the impact of immediate versus delayed feedback on patient diagnosis/management at 3 and 12 months. Results: A total of 618 subjects were randomized (1:1) to immediate or delayed feedback arms, and 602 subjects completed the 3-month primary endpoint visit. A higher proportion of patients in the immediate feedback arm showed a change in diagnosis compared to the controls (32.6 vs. 6.4%; p = 0.0001). Similarly, a higher proportion of patients receiving immediate feedback had a change in management plan (68 vs. 55.5%; p < 0.002), mainly driven by changes in AD medication. Specifically, acetylcholinesterase inhibitors were prescribed to 67% of the amyloid-positive and 27% of the amyloid-negative subjects in the information group compared with 56 and 43%, respectively, in the control group (p < 0.0001). These between-group differences persisted until the 12-month visit. Conclusion: Knowledge of the amyloid status affects the diagnosis and alters patient management.
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Dates et versions

hal-04419475 , version 1 (26-01-2024)

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Michael J Pontecorvo, Andrew Siderowf, Bruno Dubois, P Murali Doraiswamy, Giovanni B Frisoni, et al.. Effectiveness of Florbetapir PET Imaging in Changing Patient Management. Dementia and Geriatric Cognitive Disorders, 2024, 44, pp.129 - 143. ⟨10.1159/000478007⟩. ⟨hal-04419475⟩
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