title: Modeling the course of Alzheimer's disease to improve clinical trials: symposium report.
abstract: In a symposium held at the Clinical Trials in Alzheimer's Disease conference in Monte Carlo, Monaco (29 to 31 October 2012) three different, not mutually exclusive approaches to improve and facilitate clinical trials with anti-dementia drugs were presented and discussed. All three approaches are summarized in this manuscript. Core suggestions are: stratification of trial participants at the outset of studies, using cognitive and disease-course characteristics available at baseline; creating new composite cognitive scores for optimizing responsiveness to decline in early and very early Alzheimer's disease; and replacing some of the conventional long-term placebo-controlled trials in advanced stages of drug development, using the placebo group simulation approach. Future efforts should focus on incorporating, where appropriate, the suggestions provided at the symposium into clinical trials now being planned.
authors.affiliation: Department of Geriatrics, Memory Clinic, University Hospital, CH-4031 Basel, Switzerland.
authors.forename: René
authors.initials: R
authors.lastname: Spiegel
authors.affiliation: Alzheimer's Disease and Memory Disorders Center, Department of Neurology, Baylor College of Medicine, 1977 Butler Blvd, Suite E5.101, Houston, TX 77030, USA.
authors.forename: Rachelle S
authors.initials: RS
authors.lastname: Doody
authors.affiliation: Pentara Corporation, 2180 East Claybourne Avenue, Salt Lake City, UT 84109, USA.
authors.forename: Suzanne
authors.initials: S
authors.lastname: Hendrix
authors.affiliation: Global Health Outcomes, Eli Lilly & Company, Indianapolis, IN 46285, USA.
authors.forename: Kristin
authors.initials: K
authors.lastname: Kahle-Wrobleski