Statistical considerations when estimating time‐saving treatment effects in Alzheimer's disease clinical trials

Author:

Wang Guoqiao12ORCID,Cutter Gary3,Oxtoby Neil P.4,Shan Guogen5,Wang Whedy6,Mangal Brian7,Liao Yijie8,Llibre‐Guerra Jorge J.1,Li Yan1,Xiong Chengjie2,McDade Eric1,Delmar Paul9,Bateman Randall J.1,Schneider Lon10

Affiliation:

1. Department of Neurology, Division of Biostatistics, School of Medicine Washington University St. Louis Missouri USA

2. Division of Biostatistics Washington University School of Medicine St. Louis Missouri USA

3. Department of Biostatistics University of Alabama at Birmingham Birmingham Alabama USA

4. Department of Computer Science University College London London UK

5. Department of Biostatistics University of Florida Gainesville Florida USA

6. Tenaya Therapeutics South San Francisco California USA

7. Solara Consulting Corp. North Vancouver British Columbia Canada

8. Neogene Therapeutics Inc. Santa Monica California USA

9. F. Hoffmann‐La Roche Ltd. Basel Switzerland

10. Department of Psychiatry and The Behavioral Sciences Department of Neurology Keck School of Medicine University of Southern California Los Angeles California USA

Abstract

AbstractINTRODUCTIONEstimating treatment effects as time savings in disease progression may be more easily interpretable than assessing the absolute difference or a percentage reduction. In this study, we investigate the statistical considerations of the existing method for estimating time savings and propose alternative complementary methods.METHODSWe propose five alternative methods to estimate the time savings from different perspectives. These methods are applied to simulated clinical trial data that mimic or modify the Clinical Dementia Rating Sum of Boxes progression trajectories observed in the Clarity AD lecanemab trial.RESULTSOur study demonstrates that the proposed methods can generate more precise estimates by considering two crucial factors: (1) the absolute difference between treatment arms, and (2) the observed progression rate in the treatment arm.DISCUSSIONQuantifying treatment effects as time savings in disease progression offers distinct advantages. To provide comprehensive estimations, it is important to use various methods.Highlights We explore the statistical considerations of the current method for estimating time savings. We proposed alternative methods that provide time savings estimations based on the observed absolute differences. By using various methods, a more comprehensive estimation of time savings can be achieved.

Funder

National Institute on Aging

National Institutes of Health

Foundation for the National Institutes of Health

Publisher

Wiley

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