美国的阿尔茨海默氏病确认测试能力:目前的情况和未来的模拟增加
Sophie Roth1, Jessie Yan2, Maria-Magdalena Patru3
1Global Access & Policy, Roche Diagnostics International Ltd, Rotkreuz, Switzerland.
Journal of Alzheimer's disease : JAD
|January 20, 2026
概括
对阿尔茨海默病 (AD) 生物标志物检测的需求正在增加. 增加脑脊液 (CSF) 分析利用率可以满足这一需求,改善阿兹海默症患者的及时诊断.
科学领域:
- 神经学 神经学
- 生物标志物研究 生物标志物研究
- 医疗保健经济学 医疗保健经济学
背景情况:
- 阿尔茨海默病 (AD) 治疗的进步需要更多地使用确认性生物标志物测试.
- 脑脊液 (CSF) 分析和粉样质正子辐射断层扫描 (PET) 是关键的诊断工具.
- 目前在美国的阿尔茨海默病确认测试能力可能不足.
研究的目的:
- 评估目前在美国进行阿尔茨海默病确认测试的能力.
- 为了估计未来对阿尔茨海默病诊断生物标志物测试的需求.
- 为了模拟CSF分析和粉胺PET的不同利用场景.
主要方法:
- 一个基于人口的决策树模型模拟了Medicare患者的AD诊断途径.
- 该模型分析了四种场景,其中CSF分析和粉胺PET的利用率各不相同.
- 该研究采用了美国支付人的观点,在5年的时间内.
主要成果:
- 参考情景 (目前的低利用率) 显著无法满足需求,其中<2%的粉样β阳性患者得到了及时诊断.
- 增加CSF分析利用率 (50%或100%) 产生了最高比例的准确和及时诊断 (24.8%和44.6%).
- 与增加的CSF分析相比,仅用粉样蛋白PET的情况显示出较低的诊断收益率 (15.1%).
结论:
- 解决AD确认测试能力的局限性对于及时诊断和治疗启动至关重要.
- 增加CSF分析的使用率是一个可行的策略,以满足对AD生物标志物测试日益增长的需求.
- 优化诊断途径可以促进阿尔茨海默病患者获得粉样蛋白向疗法.
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