Early Alzheimer’s Detection Test Gets FDA Approval

The US Food and Drug Administration (FDA) has authorized the first diagnostic test conducted outside the living body to help diagnose early Alzheimer’s disease.

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Brand New Lumipulse

On 4 May, FDA announced it has approved Fujirebio Diagnostic’s new application for its Lumipulse G β-Amyloid Ratio (1-42/1-40) test, which is intended for patients ages 55 years and older who have shown cognitive impairment.

The test also received breakthrough device designation, meaning it was able to get through an expedited review process for products with unmet needs.

“The availability of an in vitro diagnostic test that can potentially eliminate the need for time-consuming and expensive PET scans is great news for individuals and families concerned with the possibility of an Alzheimer’s disease diagnosis,” said Jeff Shuren, director of the Center for Devices and Radiological Health (CDRH).

With the Lumipulse test, there is a new option that can typically be completed the same day and can give doctors the same information regarding brain amyloid status, without the radiation risk, to help determine if a patient’s cognitive impairment is due to Alzheimer’s disease.

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Be Cautious

FDA cautioned that the test is only meant to be used in conjunction with other clinical information to confirm if a patient has Alzheimer’s disease.

They also noted that the test carries a risk of false-positive results that could lead to unnecessary treatments and stress on patients, as well as false-negative results that could delay patient treatment.

There is an unmet need for a reliable and safe test that can accurately identify patients with amyloid plaques consistent with Alzheimer’s disease. While amyloid plaques can occur in other diseases, being able to detect the presence of plaque, along with other evaluations, helps the doctor determine the probable cause of the patient’s symptoms and findings.

Before today’s authorization, doctors used positron emission tomography (PET) scans, a potentially costly and cumbersome option, to detect/visualize amyloid plaques in a patient’s brain, often years before clinical symptom onset, to aid in diagnosing Alzheimer’s disease.

FDA based its decision to authorize the test based on a clinical study of 292 CSF samples from the Alzheimer’s Disease Neuroimaging Initiative sample bank. Samples were tested using the Lumipulse G β-amyloid Ratio (1-42/1-40) and compared to amyloid PET scan results.

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Detecting Alzheimer's Gets Easier

According to FDA, 97% of individuals tested with positive Lumipulse G β-amyloid Ratio (1-42/1-40) positive also had amyloid plaques by PET scan and 84% of individuals with negative results had a negative amyloid PET scan.

FDA’s decision to authorize the Lumipulse test comes almost one year after the agency’s controversial approval of Biogen’s Alzheimer’s disease therapy Aduhelm (aducanumab) based on a reduction in brain amyloid plaque.

Aducanumab was approved based on the results from two Phase 3 clinical trials of patients with early Alzheimer’s, though both trials were stopped in March 2019 due to apparent futility by a data safety monitoring board.

Independent experts on FDA’s Peripheral and Central Nervous System (PCNS) Drugs advisory committee voted against the drug’s approval because it had no proven efficacy.

At the time, the agency decided to grant the drug accelerated approval based on the surrogate endpoint due to the potential that a reduction in amyloid plaque will result in a reduction in Alzheimer’s disease. They hope this new diagnostic test is another jewel in the crown of Alzheimer’s disease research.



Source-Medindia