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Adapting prescribing criteria for amyloid‐targeted antibodies for adults with Down syndrome
Hampus Hillerstrom, Richard Alan Fisher, Matthew P. Janicki, Brian Allen Chicoine, Bradley T. Christian, Anna J. Esbensen, Lucille Esralew, Juan Fortea et al.. Alzheimer s & Dementia, 2024-03-13
Topic: Amyloid, tau and blood-test diagnosis
Prior authorization criteria for Federal Drug Administration (FDA) approved immunotherapeutics, among the class of anti-amyloid monoclonal antibodies (mAbs), established by state drug formulary committees, are tailored for adults with late-onset Alzheimer's disease. This overlooks adults with Down syndrome (DS), who often experience dementia at a younger age and with different diagnostic assessment outcomes. This exclusion may deny DS adults access to potential disease-modifying treatments. To address this issue, an international expert panel convened to establish adaptations of prescribing criteria suitable for DS patients and parameters for access to Centers for Medicare & Medicaid Services (CMS) registries. The panel proposed mitigating disparities by modifying CMS and payer criteria to account for younger onset age, using alternative language and assessment instruments validated for cognitive decline in the DS population. The panel also recommended enhancing prescribing clinicians' diagnostic capabilities for DS and initiated awareness-raising activities within healthcare organizations. These efforts facilitated discussions with federal officials, aimed at achieving equity in access to anti-amyloid immunotherapeutics, with implications for national authorities worldwide evaluating these and other new disease-modifying therapeutics for Alzheimer's disease.
Cite this study APA, Vancouver, BibTeX · download .bib or .ris
APA 7th
Hillerstrom, H., Fisher, R. A., Janicki, M. P., Chicoine, B. A., Christian, B. T., Esbensen, A. J., et al. (2024). Adapting prescribing criteria for amyloid‐targeted antibodies for adults with Down syndrome. Alzheimer s & Dementia. https://doi.org/10.1002/alz.13778
Vancouver
Hillerstrom H, Fisher RA, Janicki MP, Chicoine BA, Christian BT, Esbensen AJ, et al. Adapting prescribing criteria for amyloid‐targeted antibodies for adults with Down syndrome. Alzheimer s & Dementia. 2024. doi:10.1002/alz.13778. PMID: 38480678.
BibTeX
@article{hillerstrom2024-38480678,
author = {Hillerstrom, Hampus and Fisher, Richard Alan and Janicki, Matthew P. and Chicoine, Brian Allen and Christian, Bradley T. and Esbensen, Anna J. and Esralew, Lucille and Fortea, Juan and others},
title = {{Adapting prescribing criteria for amyloid‐targeted antibodies for adults with Down syndrome}},
journal = {Alzheimer s \& Dementia},
year = {2024},
doi = {10.1002/alz.13778},
pmid = {38480678},
url = {https://doi.org/10.1002/alz.13778}
}
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Key findings
- This exclusion may deny DS adults access to potential disease-modifying treatments.
- To address this issue, an international expert panel convened to establish adaptations of prescribing criteria suitable for DS patients and parameters for access to Centers for Medicare & Medicaid Services (CMS) registries.
- The panel proposed mitigating disparities by modifying CMS and payer criteria to account for younger onset age, using alternative language and assessment instruments validated for cognitive decline in the DS population.
- The panel also recommended enhancing prescribing clinicians' diagnostic capabilities for DS and initiated awareness-raising activities within healthcare organizations.
- These efforts facilitated discussions with federal officials, aimed at achieving equity in access to anti-amyloid immunotherapeutics, with implications for national authorities worldwide evaluating these and other new disease-modifying therapeutics for Alzheimer's disease.
Why it matters
This paper describes an expert panel's recommendations to adapt prescribing rules for anti-amyloid antibody treatments so that adults with Down syndrome are not excluded from access. It is about access to potential disease-modifying treatments, not about whether those treatments work.
Study details
- Evidence strengthLow
How this study scored 48/100
Published in a peer-reviewed journal. Scored zero for study design, sample size, effect reported, studied in people and randomised / blinded because the record does not state it.
| Component | Points | Why |
|---|---|---|
| Journal tier | 7 / 10 | Tier 3 — peer-reviewed journal (Alzheimer s & Dementia) |
| Journal's citation record | 2 / 4 | Alzheimer s & Dementia: journal h-index 228 (OpenAlex, 2026-10-29) |
| Study design | 0 / 12 | No study design recorded — scores zero, not guessed (not stated in the record — scored 0) |
| Strength of evidence | 1 / 5 | Rated “low” in our summary |
| Peer-review validation | 10 / 10 | Peer-reviewed. Published as an article in a named peer-reviewed journal. |
| How recent | 4 / 5 | 2024 — within 3 year(s) of the newest study here |
| Sample size | 0 / 4 | Participant count not stated — scores zero (not stated in the record — scored 0) |
| Effect reported | 0 / 3 | No effect size reported — scores zero (not stated in the record — scored 0) |
| Studied in people | 0 / 3 | Not stated whether this was studied in people — scores zero (not stated in the record — scored 0) |
| Randomised / blinded | 0 / 2 | No randomisation or blinding stated — scores zero (not stated in the record — scored 0) |
| Times cited | 3 / 7 | Cited 17 times (OpenAlex, 2026-10-10) |
| Citations per year | 2 / 5 | 4.2 citations a year over 4 year(s) since 2024 |
| Impact for its field and year | 3 / 6 | Cited 4.1× the average for papers of its field and year (OpenAlex FWCI) |
| Cited by studies here | 2 / 6 | Cited by 7 other studies in this library |
| Still being cited | 2 / 4 | Cited 17 times in 2024–2026 (2026 still in progress; OpenAlex) |
| Senior author's track record | 2 / 4 | Last-listed author Henrik Zetterberg: h-index 46 (OpenAlex, whole career) |
| Institution's track record | 3 / 3 | Harvard University: institution h-index 3,235 (OpenAlex) |
| Multi-centre collaboration | 3 / 3 | OpenAlex lists 23 institution(s) in 7 countries |
| Indexed in PubMed | 2 / 2 | Indexed in PubMed (PMID 38480678) |
| Free to read | 2 / 2 | Free to read |
| Total | 48 / 100 | — |
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