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Mahedy L, Anderson EL, Tilling K, Thornton ZA, Elmore AR, Szalma S, Simen A, Culp M, Zicha S, Harel BT, Davey Smith G, Smith EN, Paternoster L. Investigation of genetic determinants of cognitive change in later life. Transl Psychiatry 2024; 14:31. [PMID: 38238328 PMCID: PMC10796929 DOI: 10.1038/s41398-023-02726-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/14/2023] [Revised: 12/14/2023] [Accepted: 12/22/2023] [Indexed: 01/22/2024] Open
Abstract
Cognitive decline is a major health concern and identification of genes that may serve as drug targets to slow decline is important to adequately support an aging population. Whilst genetic studies of cross-sectional cognition have been carried out, cognitive change is less well-understood. Here, using data from the TOMMORROW trial, we investigate genetic associations with cognitive change in a cognitively normal older cohort. We conducted a genome-wide association study of trajectories of repeated cognitive measures (using generalised estimating equation (GEE) modelling) and tested associations with polygenic risk scores (PRS) of potential risk factors. We identified two genetic variants associated with change in attention domain scores, rs534221751 (p = 1 × 10-8 with slope 1) and rs34743896 (p = 5 × 10-10 with slope 2), implicating NCAM2 and CRIPT/ATP6V1E2 genes, respectively. We also found evidence for the association between an education PRS and baseline cognition (at >65 years of age), particularly in the language domain. We demonstrate the feasibility of conducting GWAS of cognitive change using GEE modelling and our results suggest that there may be novel genetic associations for cognitive change that have not previously been associated with cross-sectional cognition. We also show the importance of the education PRS on cognition much later in life. These findings warrant further investigation and demonstrate the potential value of using trial data and trajectory modelling to identify genetic variants associated with cognitive change.
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Affiliation(s)
- Liam Mahedy
- MRC Integrative Epidemiology Unit, University of Bristol, Bristol, BS8 2BN, UK
- Department of Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, BS8 2BN, UK
| | - Emma L Anderson
- MRC Integrative Epidemiology Unit, University of Bristol, Bristol, BS8 2BN, UK
- Department of Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, BS8 2BN, UK
| | - Kate Tilling
- MRC Integrative Epidemiology Unit, University of Bristol, Bristol, BS8 2BN, UK
- Department of Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, BS8 2BN, UK
- NIHR Bristol Biomedical Research Centre, University Hospitals Bristol and Weston, NHS Foundation Trust and University of Bristol, Bristol, BS8 2BN, UK
| | - Zak A Thornton
- MRC Integrative Epidemiology Unit, University of Bristol, Bristol, BS8 2BN, UK
- Department of Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, BS8 2BN, UK
| | - Andrew R Elmore
- MRC Integrative Epidemiology Unit, University of Bristol, Bristol, BS8 2BN, UK
- Department of Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, BS8 2BN, UK
- NIHR Bristol Biomedical Research Centre, University Hospitals Bristol and Weston, NHS Foundation Trust and University of Bristol, Bristol, BS8 2BN, UK
| | - Sándor Szalma
- Takeda Development Center Americas, Inc., San Diego, CA, USA
| | - Arthur Simen
- Takeda Development Center Americas, Inc., Cambridge, MA, USA
| | - Meredith Culp
- Takeda Development Center Americas, Inc., Cambridge, MA, USA
| | - Stephen Zicha
- Takeda Development Center Americas, Inc., Cambridge, MA, USA
| | - Brian T Harel
- Takeda Development Center Americas, Inc., Cambridge, MA, USA
| | - George Davey Smith
- MRC Integrative Epidemiology Unit, University of Bristol, Bristol, BS8 2BN, UK
- Department of Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, BS8 2BN, UK
- NIHR Bristol Biomedical Research Centre, University Hospitals Bristol and Weston, NHS Foundation Trust and University of Bristol, Bristol, BS8 2BN, UK
| | - Erin N Smith
- Takeda Development Center Americas, Inc., San Diego, CA, USA
| | - Lavinia Paternoster
- MRC Integrative Epidemiology Unit, University of Bristol, Bristol, BS8 2BN, UK.
- Department of Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, BS8 2BN, UK.
- NIHR Bristol Biomedical Research Centre, University Hospitals Bristol and Weston, NHS Foundation Trust and University of Bristol, Bristol, BS8 2BN, UK.
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Schneider LS, Bennett DA, Farlow MR, Peskind ER, Raskind MA, Sano M, Stern Y, Haneline S, Welsh-Bohmer KA, O'Neil J, Walter R, Maresca S, Culp M, Alexander R, Saunders AM, Burns DK, Chiang C. Adjudicating Mild Cognitive Impairment Due to Alzheimer's Disease as a Novel Endpoint Event in the TOMMORROW Prevention Clinical Trial. J Prev Alzheimers Dis 2022; 9:625-634. [PMID: 36281666 DOI: 10.14283/jpad.2022.72] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/16/2023]
Abstract
BACKGROUND The onset of mild cognitive impairment (MCI) is an essential outcome in Alzheimer's disease (AD) prevention trials and a compelling milestone for clinically meaningful change. Determining MCI, however, may be variable and subject to disagreement. Adjudication procedures may improve the reliability of these determinations. We report the performance of an adjudication committee for an AD prevention trial. METHODS The TOMMORROW prevention trial selected cognitively normal participants at increased genetic risk for AD and randomized them to low-dose pioglitazone or placebo treatment. When adjudication criteria were triggered, a participant's clinical information was randomly assigned to a three-member panel of a six-member independent adjudication committee. Determination of whether or not a participant reached MCI due to AD or AD dementia proceeded through up to three review stages - independent review, collaborative review, and full committee review - requiring a unanimous decision and ratification by the chair. RESULTS Of 3494 participants randomized, the committee adjudicated on 648 cases from 386 participants, resulting in 96 primary endpoint events. Most participants had cases that were adjudicated once (n = 235, 60.9%); the rest had cases that were adjudicated multiple times. Cases were evenly distributed among the eight possible three-member panels. Most adjudicated cases (485/648, 74.8%) were decided within the independent review (stage 1); 14.0% required broader collaborative review (stage 2), and 11.1% needed full committee discussion (stage 3). The primary endpoint event decision rate was 39/485 (8.0%) for stage 1, 29/91 (31.9%) for stage 2, and 28/72 (38.9%) for stage 3. Agreement between the primary event outcomes supported by investigators' clinical diagnoses and the decisions of the adjudication committee increased from 50% to approximately 93% (after around 100 cases) before settling at 80-90% for the remainder of the study. CONCLUSIONS The adjudication process was designed to provide independent, consistent determinations of the trial endpoints. These outcomes demonstrated the extent of uncertainty among trial investigators and agreement between adjudicators when the transition to MCI due to AD was prospectively assessed. These methods may inform clinical endpoint determination in future AD secondary prevention studies. Reliable, accurate assessment of clinical events is critical for prevention trials and may mean the difference between success and failure.
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Affiliation(s)
- L S Schneider
- Lon S. Schneider, Keck School of Medicine of USC, 1540 Alcazar St, CHP216, Los Angeles CA, 90033, USA, Phone no: +1 323 442 7600,
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Burns DK, Alexander RC, Welsh-Bohmer KA, Culp M, Chiang C, O'Neil J, Evans RM, Harrigan P, Plassman BL, Burke JR, Wu J, Lutz MW, Haneline S, Schwarz AJ, Schneider LS, Yaffe K, Saunders AM, Ratti E. Safety and efficacy of pioglitazone for the delay of cognitive impairment in people at risk of Alzheimer's disease (TOMMORROW): a prognostic biomarker study and a phase 3, randomised, double-blind, placebo-controlled trial. Lancet Neurol 2021; 20:537-547. [PMID: 34146512 DOI: 10.1016/s1474-4422(21)00043-0] [Citation(s) in RCA: 50] [Impact Index Per Article: 16.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2020] [Revised: 12/14/2020] [Accepted: 02/02/2021] [Indexed: 12/01/2022]
Abstract
BACKGROUND The identification of people at risk of cognitive impairment is essential for improving recruitment in secondary prevention trials of Alzheimer's disease. We aimed to test and qualify a biomarker risk assignment algorithm (BRAA) to identify participants at risk of developing mild cognitive impairment due to Alzheimer's disease within 5 years, and to evaluate the safety and efficacy of low-dose pioglitazone to delay onset of mild cognitive impairment in these at-risk participants. METHODS In this phase 3, multicentre, randomised, double-blind, placebo-controlled, parallel-group study, we enrolled cognitively healthy, community living participants aged 65-83 years from 57 academic affiliated and private research clinics in Australia, Germany, Switzerland, the UK, and the USA. By use of the BRAA, participants were grouped as high risk or low risk. Participants at high risk were randomly assigned 1:1 to receive oral pioglitazone (0·8 mg/day sustained release) or placebo, and all low-risk participants received placebo. Study investigators, site staff, sponsor personnel, and study participants were masked to genotype, risk assignment, and treatment assignment. The planned study duration was the time to accumulate 202 events of mild cognitive impairment due to Alzheimer's disease in White participants who were at high risk (the population on whom the genetic analyses that informed the BRAA development was done). Primary endpoints were time-to-event comparisons between participants at high risk and low risk given placebo (for the BRAA objective), and between participants at high risk given pioglitazone or placebo (for the efficacy objective). The primary analysis included all participants who were randomly assigned, received at least one dose of study drug, and had at least one valid post-baseline visit, with significance set at p=0·01. The safety analysis included all participants who were randomly assigned and received at least one dose of study medication. An efficacy futility analysis was planned for when approximately 33% of the anticipated events occurred in the high-risk, White, non-Hispanic or Latino group. This trial is registered with ClinicalTrials.gov, NCT01931566. FINDINGS Between Aug 28, 2013, and Dec 21, 2015, we enrolled 3494 participants (3061 at high risk and 433 at low risk). Of those participants, 1545 were randomly assigned to pioglitazone and 1516 to placebo. 1104 participants discontinued treatment (464 assigned to the pioglitazone group, 501 in the placebo high risk group, and 139 in the placebo low risk group). 3399 participants had at least one dose of study drug or placebo and at least one post-baseline follow-up visit, and were included in the efficacy analysis. 3465 participants were included in the safety analysis (1531 assigned to the pioglitazone group, 1507 in the placebo high risk group, and 427 in the placebo low risk group). In the full analysis set, 46 (3·3%) of 1406 participants at high risk given placebo had mild cognitive impairment due to Alzheimer's disease, versus four (1·0%) of 402 participants at low risk given placebo (hazard ratio 3·26, 99% CI 0·85-12·45; p=0·023). 39 (2·7%) of 1430 participants at high risk given pioglitazone had mild cognitive impairment, versus 46 (3·3%) of 1406 participants at high risk given placebo (hazard ratio 0·80, 99% CI 0·45-1·40; p=0·307). In the safety analysis set, seven (0·5%) of 1531 participants at high risk given pioglitazone died versus 21 (1·4%) of 1507 participants at high risk given placebo. There were no other notable differences in adverse events between groups. The study was terminated in January, 2018, after failing to meet the non-futility threshold. INTERPRETATION Pioglitazone did not delay the onset of mild cognitive impairment. The biomarker algorithm demonstrated a 3 times enrichment of events in the high risk placebo group compared with the low risk placebo group, but did not reach the pre-specified significance threshold. Because we did not complete the study as planned, findings can only be considered exploratory. The conduct of this study could prove useful to future clinical development strategies for Alzheimer's disease prevention studies. FUNDING Takeda and Zinfandel.
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Affiliation(s)
| | | | - Kathleen A Welsh-Bohmer
- Joseph and Kathleen Bryan Alzheimer's Disease Research Center, Duke University Medical Center, Durham, NC, USA
| | - Meredith Culp
- Takeda Development Center Americas, Cambridge, MA, USA
| | | | - Janet O'Neil
- Takeda Development Center Americas, Deerfield, IL, USA
| | | | | | - Brenda L Plassman
- Joseph and Kathleen Bryan Alzheimer's Disease Research Center, Duke University Medical Center, Durham, NC, USA
| | - James R Burke
- Joseph and Kathleen Bryan Alzheimer's Disease Research Center, Duke University Medical Center, Durham, NC, USA; Department of Neurology, Duke University Medical Center, Durham, NC, USA
| | - Jingtao Wu
- Takeda Development Center Americas, Cambridge, MA, USA
| | - Michael W Lutz
- Joseph and Kathleen Bryan Alzheimer's Disease Research Center, Duke University Medical Center, Durham, NC, USA; Department of Neurology, Duke University Medical Center, Durham, NC, USA
| | | | | | - Lon S Schneider
- Keck School of Medicine of the University of Southern California, Los Angeles, CA, USA
| | - Kristine Yaffe
- University of California at San Francisco, San Francisco, CA, USA
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Lutz MW, Burns DK, Alexander R, Culp M, Yarnall D, Haneline S, Chiang C, Lai E, Metz C, Sundseth S, Guennel T, Marshall S, Andruss BF, Latham GJ, Hall B, Statt SN, Swanson T, Ratti E, Saunders AM. A genetic enrichment strategy for delay of onset of Alzheimer’s disease clinical trials. Alzheimers Dement 2020. [DOI: 10.1002/alz.044920] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Affiliation(s)
| | | | | | - Meredith Culp
- Takeda Development Center Americas, Inc. Cambridge MA USA
| | | | | | - Carl Chiang
- Zinfandel Pharmaceuticals, Inc. Chapel Hill NC USA
| | - Eric Lai
- Takeda Development Center Americas, Inc. Cambridge MA USA
| | - Craig Metz
- Zinfandel Pharmaceuticals, Inc. Chapel Hill NC USA
| | | | - Tobi Guennel
- QuartzBio, part of Precision for Medicine Frederick MD USA
| | - Scott Marshall
- QuartzBio, part of Precision for Medicine Frederick MD USA
| | | | | | | | | | - Tom Swanson
- Zinfandel Pharmaceuticals, Inc. Chapel Hill NC USA
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Burns DK, Chiang C, Welsh-Bohmer KA, Brannan SK, Culp M, O'Neil J, Runyan G, Harrigan P, Plassman BL, Lutz M, Lai E, Haneline S, Yarnall D, Yarbrough D, Metz C, Ponduru S, Sundseth S, Saunders AM. The TOMMORROW study: Design of an Alzheimer's disease delay-of-onset clinical trial. Alzheimers Dement (N Y) 2019; 5:661-670. [PMID: 31720367 PMCID: PMC6838537 DOI: 10.1016/j.trci.2019.09.010] [Citation(s) in RCA: 26] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
Introduction Alzheimer's disease (AD) is a continuum with neuropathologies manifesting years before clinical symptoms; thus, AD research is attempting to identify more disease-modifying approaches to test treatments administered before full disease expression. Designing such trials in cognitively normal elderly individuals poses unique challenges. Methods The TOMMORROW study was a phase 3 double-blind, parallel-group study designed to support qualification of a novel genetic biomarker risk assignment algorithm (BRAA) and to assess efficacy and safety of low-dose pioglitazone to delay onset of mild cognitive impairment due to AD. Eligible participants were stratified based on the BRAA (using TOMM40 rs 10524523 genotype, Apolipoprotein E genotype, and age), with high-risk individuals receiving low-dose pioglitazone or placebo and low-risk individuals receiving placebo. The primary endpoint was time to the event of mild cognitive impairment due to AD. The primary objectives were to compare the primary endpoint between high- and low-risk placebo groups (for BRAA qualification) and between high-risk pioglitazone and high-risk placebo groups (for pioglitazone efficacy). Approximately 300 individuals were also asked to participate in a volumetric magnetic resonance imaging substudy at selected sites. Results The focus of this paper is on the design of the study; study results will be presented in a separate paper. Discussion The design of the TOMMORROW study addressed many key challenges to conducting a dual-objective phase 3 pivotal AD clinical trial in presymptomatic individuals. Experiences from planning and executing the TOMMORROW study may benefit future AD prevention/delay-of-onset trials.
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Affiliation(s)
| | - Carl Chiang
- Zinfandel Pharmaceuticals, Inc., Durham, NC, USA
| | - Kathleen A Welsh-Bohmer
- Department of Neurology, Bryan Alzheimer's Disease Research Center, Duke University School of Medicine, Durham, NC, USA
| | | | - Meredith Culp
- Takeda Development Center Americas, Inc., Deerfield, IL, USA
| | - Janet O'Neil
- Takeda Development Center Americas, Inc., Deerfield, IL, USA
| | - Grant Runyan
- Takeda Development Center Americas, Inc., Deerfield, IL, USA
| | | | - Brenda L Plassman
- Department of Neurology, Bryan Alzheimer's Disease Research Center, Duke University School of Medicine, Durham, NC, USA
| | - Michael Lutz
- Department of Neurology, Bryan Alzheimer's Disease Research Center, Duke University School of Medicine, Durham, NC, USA
| | - Eric Lai
- Takeda Development Center Americas, Inc., Deerfield, IL, USA
| | | | | | | | - Craig Metz
- Zinfandel Pharmaceuticals, Inc., Durham, NC, USA
| | - Sridevi Ponduru
- Takeda Development Center Americas, Inc., Cambridge, MA, USA
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Welsh-Bohmer KA, Atkins AS, Plassman BL, Khan A, Chiang C, Culp M, O'Neil J, Walter R, Haneline S, Arbuckle J, Brewster S, Maruyama Y, Swanson T, Hayden KM, Romero H, Keefe RSE, Saunders AM, Burns DK, Alexander R. O4-11-02: DEFINING COGNITION IN PRE-DEMENTIA CLINICAL TRIALS: BASELINE NEUROPSYCHOLOGICAL DATA FROM THE TOMMORROW STUDY. Alzheimers Dement 2019. [DOI: 10.1016/j.jalz.2019.06.4801] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Affiliation(s)
- Kathleen A. Welsh-Bohmer
- Department of Psychiatry; Duke Clinical Research Institute; Durham NC USA
- VeraSci Corporation; Durham NC USA
| | | | | | - Anzalee Khan
- VeraSci Corporation; Durham NC USA
- Nathan S. Kline Institute for Psychiatric Research; Orangeburg NY USA
| | - Carl Chiang
- Zinfandel Pharmaceuticals, Inc.; Durham NC USA
| | - Meredith Culp
- Takeda Development Center Americas Inc.; Deerfield IL USA
| | - Janet O'Neil
- Takeda Development Center Americas Inc.; Deerfield IL USA
| | | | | | | | | | | | - Tom Swanson
- Zinfandel Pharmaceuticals, Inc.; Chapel Hill NC USA
| | | | - Heather Romero
- Bryan Alzheimer's Disease Research Center; Duke University; Durham NC USA
| | - Richard SE. Keefe
- VeraSci Corporation; Durham NC USA
- Department of Psychiatry; Duke University Medical Center; Durham NC USA
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Alexander R, Burns DK, Welsh-Bohmer KA, Burke JR, Chiang C, Culp M, Plassman BL, Wu J, Lutz MW, Rubens R, Evans R, Saunders AM, Ratti E. DT-02-02: TOMMORROW: RESULTS FROM A PHASE 3 TRIAL TO DELAY THE ONSET OF MCI DUE TO AD AND QUALIFY A GENETIC BIOMARKER ALGORITHM. Alzheimers Dement 2019. [DOI: 10.1016/j.jalz.2019.08.011] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Affiliation(s)
| | | | | | - James R. Burke
- Bryan Alzheimer's Disease Research Center; Duke University; Durham NC USA
- Duke University Medical Center; Durham NC USA
| | - Carl Chiang
- Zinfandel Pharmaceuticals, Inc.; Durham NC USA
| | - Meredith Culp
- Takeda Development Center Americas, Inc.; Deerfield IL USA
| | - Brenda L. Plassman
- Bryan Alzheimer's Disease Research Center; Duke University; Durham NC USA
| | - Jingtao Wu
- Takeda Development Center Americas, Inc.; Cambridge MA USA
| | | | - Robert Rubens
- Takeda Development Center Americas, Inc.; Cambridge MA USA
| | - Rebecca Evans
- Takeda Development Center Americas, Inc.; Cambridge MA USA
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Chiang C, Alexander R, Welsh-Bohmer KA, Plassman BL, Romero H, Hayden KM, Keefe RSE, Atkins AS, Harrigan P, O'Neil J, Culp M, Walter R, Wu J, Randle L, Haneline S, Yarbrough D, Metz C, Burns DK, Saunders AM. P1‐050: ADJUDICATING MILD COGNITIVE IMPAIRMENT DUE TO ALZHEIMER'S DISEASE AS A NOVEL ENDPOINT EVENT IN THE TOMMORROW STUDY: A DELAY‐OF‐ONSET PHASE 3 CLINICAL TRIAL. Alzheimers Dement 2018. [DOI: 10.1016/j.jalz.2018.06.051] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Affiliation(s)
| | | | | | | | - Heather Romero
- Bryan Alzheimer's Disease Research CenterDuke UniversityDurhamNCUSA
| | | | - Richard SE. Keefe
- NeuroCog TrialsDurhamNCUSA
- Department of PsychiatryDuke University Medical CenterDurhamNCUSA
| | | | | | - Janet O'Neil
- Takeda Development Center Americas Inc.DeerfieldILUSA
| | - Meredith Culp
- Takeda Development Center Americas Inc.DeerfieldILUSA
| | | | - Jingtao Wu
- Takeda Development Center Americas Inc.DeerfieldILUSA
| | | | | | | | - Craig Metz
- Zinfandel Pharmaceuticals, Inc.DurhamNCUSA
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Welsh‐Bohmer KA, Plassman BL, Chiang C, Culp M, Harrigan P, O'Neil J, Walter R, Haneline S, Arbuckle J, Brewster S, Maruyama Y, Swanson T, Fitzsimmons D, Atkins AS, Keefe RS, Burns DK, Martenyi F. [P1–059]: APPROACHES TO SUBJECT RETENTION IN A PHASE 3 DELAY‐OF‐ONSET OF MILD COGNITIVE IMPAIRMENT DUE TO ALZHEIMER's DISEASE (MCI‐AD) CLINICAL TRIAL: THE TOMMORROW STUDY EXPERIENCE. Alzheimers Dement 2017. [DOI: 10.1016/j.jalz.2017.06.126] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Affiliation(s)
| | | | - Carl Chiang
- Zinfandel Pharmaceuticals, Inc.Chapel HillNCUSA
| | - Meredith Culp
- Takeda Development Center Americas, Inc.DeerfieldILUSA
| | | | - Janet O'Neil
- Takeda Development Center Americas, Inc.DeerfieldILUSA
| | - Ryan Walter
- Takeda Development Center Americas, Inc.DeerfieldILUSA
| | | | | | | | | | - Tom Swanson
- Zinfandel Pharmaceuticals, Inc.Chapel HillNCUSA
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Martenyi F, Welsh-Bohmer KA, Plassman BL, Harrigan P, Chiang C, O'Neil J, Runyan G, Culp M, Lutz MW, Lai E, Saunders AM, Haneline S, Yarnall D, Yarbrough D, Metz C, Burns DK, Roses AD. P4‐383: Characterization of the Screened Population for the Tommorrow Study: a Pharmacogenetics‐Supported Clinical Trial to Delay the Onset of Mild Cognitive Impairment Due to Alzheimer’S Disease. Alzheimers Dement 2016. [DOI: 10.1016/j.jalz.2016.07.129] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Affiliation(s)
| | | | | | | | | | - Janet O'Neil
- Takeda Development Center Americas, Inc.DeerfieldIL USA
| | - Grant Runyan
- Takeda Development Center Americas, Inc.DeerfieldIL USA
| | - Meredith Culp
- Takeda Development Center Americas, Inc.DeerfieldIL USA
| | | | - Eric Lai
- Takeda Development Center Americas, Inc.DeerfieldIL USA
| | | | | | | | | | - Craig Metz
- Zinfandel Pharmaceuticals, Inc.DurhamNC USA
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