Affordable Access

Access to the full text

Effectiveness of Florbetapir PET Imaging in Changing Patient Management

Authors
  • Pontecorvo, Michael J.
  • Siderowf, Andrew
  • Dubois, Bruno
  • Doraiswamy, P. Murali
  • Frisoni, Giovanni B.
  • Grundman, Michael
  • Nobili, Flavio
  • Sadowsky, Carl H.
  • Salloway, Stephen
  • Arora, Anupa K.
  • Chevrette, Antoine
  • Deberdt, Walter
  • Dell'Agnello, Grazia
  • Flitter, Matthew
  • Galante, Nick
  • Lowrey, Mark J.
  • Lu, Ming
  • McGeehan, Anne
  • Devous Sr., Michael D.
  • Mintun, Mark A.
Type
Published Article
Journal
Dementia and Geriatric Cognitive Disorders
Publisher
S. Karger AG
Publication Date
Aug 05, 2017
Volume
44
Issue
3-4
Pages
129–143
Identifiers
DOI: 10.1159/000478007
PMID: 28787712
Source
Karger
Keywords
License
Green
External links

Abstract

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.

Report this publication

Statistics

Seen <100 times