The approval of a disease-modifying treatment for Alzheimer's disease: impact and consequences for the nuclear medicine community.

The use of amyloid PET imaging as surrogate outcome measure of the effect of anti-AD drugs is a more complex matter and has been less explored. This article is part of the Topical Collection on Neurology On June 7th, 2021, for the first time since 2003, a novel drug against Alzheimer's disease (AD), aducanumab (Aduhelm™), has been approved in the USA by the Food and Drug Administration (FDA). We will focus here on two main aspects directly concerning our clinical and research practice: (1) using amyloid PET imaging as eligibility criterion and anticipating the associated needs, and (2) evaluating amyloid PET readout changes as surrogate outcome measures in clinical trials. SUVr is a biased measure for assessment of reduction of amyloid load after a pharmacotherapeutic intervention, as it shows a "reduction" in amyloid load over time in AD patients that in fact is an artefact linked with the perfusion reduction in cortical areas that occurs in AD patients over time [[24]]. [Extracted from the article]