Table 2

- Consensus recommendations regarding clinical practice and resource requirements for developing AD immunotherapy programs in Saudi Arabia.

Clinical practice recommendations
  • - A multidisciplinary cognitive and behavioral neurology clinic setting is required for AD immunotherapy programs.

  • - Supervision by neurologists, geriatricians and/or psychiatrists with subspecialty training in behavioral neurology is required.

  • - Offering treatment only to amnestic MCI or early AD patients who otherwise meet criteria for being good candidates for treatment, excluding patients with moderate and severe patients with AD, and patients with other forms of dementia or history or cerebrovascular events.

  • - Adherence to protocols of pivotal clinical trial of each of the immunotherapeutic agents being used, particularly with regards to inclusion criteria, dosing, neuropsychological and biomarker assessment, and frequent safety monitoring to detect and minimize the risks of ARIA.

  • - Collection of phase 4 data for medications not sufficiently demonstrated to be effective and safe in Saudi AD patients by extrapolation of data from phase III clinical trials

Resources and infrastructure
  • - Recruitment and training of neurologists, geriatricians, and/or geriatric psychiatrists in cognitive and behavioral neurology or dementia

  • - Recruitment and training of neuropsychologists, psychotherapists and key supportive staff to work in dementia clinics

  • - Validating the minimum neuropsychological and behavioral psychometric tools: ADAS-Cog 13, MMSE, CDR, NPI, MCI-ADCS, others.

  • - Regular and immediate access to MRI scans- Access to reliable amyloid tests: amyloid PET scans and amyloid tracers

  • - Access to reliable and widely available testing of CSF a-beta42 and p-tau, apoE4 genetic testing