Real‐world determinants of time to initiation of anti‐amyloid treatments: comparative data from private and academic practice settings
Varun Mehta, Divya Singh, Jordyn Kelman, Saanvi Nimma, Helen Lutz, Andrea Schnee, David Weisman, Michael H. RosenbloomAbstract
INTRODUCTION
Earlier anti‐amyloid therapy (AAT) initiation results in improved clinical outcomes in Alzheimer's disease (AD). We sought to identify demographic, clinical, and disease‐related factors impacting door‐to‐treatment times (DTTs).
METHODS
A retrospective review of AAT data was conducted at private and academic neurological practices.
RESULTS
A total of 329 patients (53.2% from private versus 46.8% academic practices), mean age 73.5 ± 7.2 (55.3% female), with most being non‐Hispanic White were treated with lecanemab (81.2%) or donanemab (18.2%). DTTs were significantly reduced ( p < 0.05) in both practices when diagnosis was confirmed with blood‐based biomarkers (BBBs) as well as with greater clinic experience dosing AATs. DTT increased in patients with non‐Medicare insurance and was not impacted by diagnosis, referral source, apolipoprotein E genotype status, or clinic distance.
DISCUSSION
Patients with private insurance may experience greater delay in DTT, whereas BBBs may reduce DTT relative to traditional confirmatory biomarkers. DTT improves with clinic experience.