Novel drug candidates targeting Alzheimer's disease: ethical challenges with identifying the relevant patient population.

Autor:	Gustavsson E; Centre for Applied Ethics, Department of Culture and Society, Linköping University, Linköping, Sweden erik.gustavsson@liu.se.; National Centre for Priorities in Health, Department of Health, Medicine and Caring sciences, Linköping University, Linköping, Sweden., Raaschou P; Clinical Pharmacology Unit, Clinical Epidemiology Division, Department of Medicine, Karolinska Institutet, Stockholm, Sweden., Lärfars G; Health and Medical Care Administration, Region Stockholm, Stockholm, Sweden., Sandman L; National Centre for Priorities in Health, Department of Health, Medicine and Caring sciences, Linköping University, Linköping, Sweden., Juth N; Stockholm Centre of Healthcare Ethics, LIME, Karolinska Institute, Stockholm, Sweden.
Jazyk:	angličtina
Zdroj:	Journal of medical ethics [J Med Ethics] 2021 Sep; Vol. 47 (9), pp. 608-614. Date of Electronic Publication: 2021 Jun 11.
DOI:	10.1136/medethics-2021-107304
Abstrakt:	Intensive research is carried out to develop a disease-modifying drug for Alzheimer's disease (AD). The development of drug candidates that reduce Aß or tau in the brain seems particularly promising. However, these drugs target people at risk for AD, who must be identified before they have any, or only moderate, symptoms associated with the disease. There are different strategies that may be used to identify these individuals (eg, population screening, cascade screening, etc). Each of these strategies raises different ethical challenges. In this paper, we analyse these challenges in relation to the risk stratification for AD necessary for using these drugs. We conclude that the new drugs must generate large health benefits for people at risk of developing AD to justify the ethical costs associated with current risk stratification methods, benefits much larger than current drug candidates have. This conclusion raises a new set of ethical questions that should be further discussed. Competing Interests: Competing interests: None declared. (© Author(s) (or their employer(s)) 2021. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.)
Databáze:	MEDLINE
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