ALZHEIMER PRECISION MEDICINE INITIATIVE
Precision Medicine (PM) in Alzheimer’s Disease hypothesizes that an individual’s unique characteristics play a key role in both vulnerability to neurodegenerative diseases and in response to present and future therapies. The dramatic rate of failure (99.7%) of clinical trials investigating treatments with putative disease-modifying effects has suggests that the "magic bullet - one size fits all" model to develop and administrate drugs is probably unrealistic.
The main objectives of Precision Medicine are:
· to predict an individual’s susceptibility to developing Alzheimer’s Disease in the asymptomatic preclinical phase
· to achieve an accurate Alzheimer’s Disease detection and diagnosis targeting early pathophysiological alterations over the preclinical course
· to optimize patients’ assignment to treatments more likely to be beneficial with the lowest risk of adverse events
These aims will only be accomplished through investigation of Alzheimer’s Disease at systems levels, as assessed by systems biology and systems neurophysiology approaches which implies the investigation of Alzheimer’s Disease through the use of multi-modal biomarkers (body fluids, functional and structural neuroimaging, electrophysiological measures) integrated with clinical data, including environmental exposures, lifestyle, and medical history.
The implementation of traditional medicine with a systems-wide approach for the study of Alzheimer’s Disease will:
· provide earlier and more accurate measures of risk prediction, diagnosis, and prognosis (ideally in the preclinical phases)
· guide and support the development of treatments tailored to the single individual according to her/his biological make-up from (epi)genetic background to overexpressed molecular pathways ultimately to brain imaging endophenotype, i.e. pathway(s)-based therapies.
· redesign the current clinical landscape and taxonomy of neurodegenerative diseases
Precision Medicine will provide physicians with reliable tools to treat neurodegenerative diseases, including Alzheimer’s Disease, during preclinical stages preventing or at least delaying the conversion to dementia. Preventive strategies for Alzheimer’s Disease are expected to significantly reduce the burden on families and health care facilities.
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