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Clinical Trial Design Issues in Mild to Moderate Alzheimer Disease

Knopman, David S. MD

Cognitive and Behavioral Neurology: December 2008 - Volume 21 - Issue 4 - p 197-201
doi: 10.1097/WNN.0b013e318190cf75
Review Article

The field of clinical trials and therapeutics in Alzheimer disease (AD) is little more than 20 years old. Considerable progress has been made in crafting appropriate designs for clinical trials of promising therapeutic agents for AD. This article reviews basic issues in diagnostic criteria, choice of outcome measures, duration of trials and analytic strategies. Through trial and error, a general set of strategies has evolved for the assessment of putative therapies for mild to moderate AD. The experience of the past 2 decades has set the stage for discovering the next generation of anti-AD drugs and introducing those therapies at milder stages of the disease.

Department of Neurology, Mayo Clinic, Rochester, MN

Supported by grants U01 AG 06786 (Mayo Alzheimer's Disease Patient Registry) and P50 AG 16574 (Mayo Alzheimer's Disease Research Center) from the National Institute on Aging.

Reprints: David S. Knopman, MD, Department of Neurology, Mayo Clinic, 200 First Street SW, Rochester, MN 55905 (e-mail:

Received for publication August 13, 2008; accepted September 30, 2008

Disclosures: David S. Knopman has served on a Data Safety Monitoring Board for Sanofi-Aventis Pharmaceuticals, and is an investigator in a clinical trial sponsored by Elan Pharmaceuticals.

© 2008 Lippincott Williams & Wilkins, Inc.