STAGE and the Promise and Challenges of New Alzheimer’s Drug Therapies
By: Karen Holzberger, President & CEO of SpinTech MRI
Radiologists, neurologists, Alzheimer’s patients and their families are rightfully encouraged by the range of new drugs in development to slow or reduce cognitive decline. At the start of 2023 there were 187 trials for 141 drugs addressing Alzheimer’s pathologies. Two drugs, aducanumab and lecanemab, have received accelerated FDA approval in the past two years. A third, donanemab has completed late-stage clinical trials and is expected to be considered for similar approval shortly.
That’s promising news for the more than 6 million people in the U.S. and 50 million worldwide currently with Alzheimer’s or dementia. The number and variety of drug trials also indicates the urgency of efforts to find treatments for a disease expected to affect 12.7 million Americans and 50 million people worldwide by 2050.
We’re following these developments closely because the imaging sequences, 30% faster scans and clearer images enabled by our STAGE software platform can rapidly and cost-effectively address many of the challenges that MRI facilities expect in order to support the new drug treatments and trials.
Concerns and challenges
The new drugs come with concerns related to the speed of regulatory approvals, estimated annual costs exceeding $25,000 per patient, and potentially serious side effects including cerebral microbleeds (CMBs).
Radiologists and neurologists also are weighing how to handle the increased volume of MRI exams needed for monitoring treatment efficacy and side effects. For example, appropriate use recommendations for the approved aducanumab and lecanemab therapies require pre-treatment scans followed by 3 to 5 more during the first year. A May 2023 article in the journal Alzheimer’s & Dementia: Translational Research & Clinical Interventions also reports that more than 57,000 patients will be needed for all currently registered trials.
Many MRI facilities are already limited by financial pressures, scanner availability, heavy radiologist workloads and technical staff shortages. Scanner field strength, available sequences, and other requirements for surveillance exams could also raise hurdles. The Alzheimer’s Disease Neuroimaging Initiative (ADNI) notes that there is a wide range of capabilities and operating characteristics both within and between different manufacturers’ product lines.
Clinical and financial benefits
At the same time, providing advanced state-of-the-art care and imaging for Alzheimer’s patients could provide a much-needed revenue boost for many hospitals still recovering from pandemic-related declines. A recent analysis published in JAMA Internal Medicine found that MRI surveillance exams for Alzheimer’s treatments would result in Medicare payments of between $91.5 million and $231.3 million annually.
How STAGE can help
First developed to give neurology researchers worldwide greater access advanced multi-sequence data and images, STAGE software has been enhanced and adapted for everyday clinical use.
STAGE taps the underlying physics of virtually all makes and models of scanners to acquire fully sampled image data faster than conventional protocols. STAGE post-processing provides up to 14 outputs including SWI and T2* mapping, while improving image clarity, contrast and signal-to-noise ratio for more efficient reads and greater diagnostic confidence. Shorter MRI exams also improve scanner utilization and patient experiences.
Finally, STAGE does not require changes to existing workflows and produces standardized data output to enable longitudinal or multi-scanner studies.
A timely solution
STAGE comes at a key time for the diagnosis and treatment of Alzheimer’s and dementia. It also is well-timed to meet the growing challenges and opportunities for treating a wide range of neurological diseases among the aging U.S. population.
For more information about STAGE or to arrange a free consultation, please visit our website or contact us at https://spintechmri.com/contact/
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