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Comment & Response
December 2019

Biomarker-Informed Treatment Decisions in Cognitively Impaired Patients Do Not Apply to Preclinical Alzheimer Disease—Reply

Author Affiliations
  • 1Department of Neurology, University of Michigan, Ann Arbor
  • 2Veterans Affairs Center for Clinical Management Research, Ann Arbor, Michigan
  • 3Institute for Healthcare Policy and Innovation, University of Michigan, Ann Arbor
  • 4Division of General Medicine, Department of Internal Medicine, University of Michigan, Ann Arbor
  • 5Institute for Social Research, University of Michigan, Ann Arbor
  • 6Institute of Gerontology, University of Michigan, Ann Arbor
JAMA Intern Med. 2019;179(12):1737. doi:10.1001/jamainternmed.2019.5078

In Reply We agree with Rabinovici and Carrillo that current guidelines identify preclinical Alzheimer disease (AD) as a research concept and that asymptomatic individuals should not be tested for AD biomarkers. Our Viewpoint1 encourages discussion about the implications for the future use of amyloid positron emission tomography (PET) imaging if one of the preclinical AD medications being tested in randomized clinical trials (eg, solanezumab) is found to be effective. At that point, use of amyloid PET would likely become much more common in the clinical setting to identify individuals who could benefit from treatment.

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