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Faculty & Disclosures

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    Faculty & Disclosures
    Prof. Jeffrey Cummings

    University of Nevada, Las Vegas, NV, USA

    Jeffrey Cummings, MD ScD, is the Joy Chambers-Grundy professor of brain science, director of the Chambers-Grundy Center for Transformative Neuroscience, and co-director of the Pam Quirk Brain Health and Biomarker Laboratory, Department of Brain Health, School of Integrated Health Sciences, University of Nevada Las Vegas (UNLV), USA. read more

    Prof. Cummings is globally recognized for his contributions to Alzheimer’s disease research, drug development and clinical trials. He has been recognized for his research and leadership contributions in the field of Alzheimer’s disease through many awards, including the Ronald and Nancy Reagan Research Award of the National Alzheimer’s Association (2008), the Distinguished Scientist Award from the American Association of Geriatric Psychiatry (2010), a Lifetime Achievement Award from the Society for Behavioral and Cognitive Neurology (2017), the Bengt Winblad Lifetime Achievement Award from the Alzheimer’s Association (2019), and the Alzheimer’s Drug Discovery Foundation’s Melvin R Goodes Prize.

    Prof. Cummings was formerly director of the Mary S Easton Center for Alzheimer’s Disease Research at UCLA and director of the Cleveland Clinic Lou Ruvo Center for Brain Health. His interests embrace clinical trials, developing new therapies for brain diseases, and the interface of neuroscience and society. Prof. Cummings has authored or edited 43 books and published over 900 peer-reviewed papers.  

    Prof. Jeffrey Cummings discloses: Advisory board or panel fees from Acadia, Biogen, Genentech, Grifols, Janssen, Karuna, Otsuka, ReMYND, Roche and Signant Health. Consulting fees from Acadia, Acumen, ALZpath, Artery, Biogen, Biohaven, Bristol Myers Squibb, Eisai, Eli Lilly, EQT Life Sciences (formerly LSP), Fosun, GAP Foundation, Janssen, Karuna, Kinoxis, Lighthouse, Lundbeck, Merck, MoCA Cognition, New Amsterdam Pharma, Novo Nordisk, Optoceutics, Otsuka, Oxford Brain Diagnostics, Praxis, Prothena, ReMYND, Roche, Scottish Brain Sciences, Signant Health, Simcere, Sinaptica, TrueBinding and Vaxxinity. Grants/research support from the National Institute of General Medical Sciences and the National Institute on Aging. Other financial or material support from Neuropsychiatric Inventory (NPI) copyright. Stock/shareholder (self-managed) from Acumen, Alzheon, Artery, Behrens, MedAvante-Prophase and Vaxxinity.
    Prof. Krista Lanctôt

    University of Toronto, ON, Canada

    Krista L Lanctôt has a PhD in clinical pharmacology from the University of Toronto, and holds the Bernick chair in geriatric psychopharmacology. She is a senior scientist in geriatric psychiatry and in the Hurvitz Brain Sciences Program at Sunnybrook Research Institute, research co-director in the Department of Psychiatry at Sunnybrook Health Sciences Centre and the head of neuropsychopharmacology research. She is also a professor of psychiatry and of pharmacology/toxicology, and vice chair of basic and clinical sciences in the Department of Psychiatry at the University of Toronto, Toronto, ON, Canada. read more

    Prof. Lanctôt is an active researcher with more than 400 published papers, and editor of the 2021 book “Apathy: Clinical and Neuroscientific Perspectives from Neurology and Psychiatry”. Her group’s research has focused on optimizing the treatment of cognition and neuropsychiatric symptoms associated with dementia and in predementia states. She has designed and executed clinical trials evaluating novel treatments of agitation in dementia.

    Prof. Krista Lanctôt discloses: Advisory board or panel fees from Bright Minds, Exciva, Lundbeck, Novo Nordisk and Otsuka, and Boehringer Ingelheim (relationship terminated). Consulting fees from Bristol Myers Squibb, Cerevel Therapeutics, Exciva, Ironshore Pharma, Kondor Pharma (relationship terminated) and Praxis Therapeutics. Grants/research support from Cerevel Therapeutics. Speaker Bureau fees from Eisai Co., Ltd, Lundbeck and Novo Nordisk (all relationships terminated).
    Prof. James Galvin

    University of Miami, FL, USA

    James E Galvin, MD, MPH, is professor of neurology and psychiatry & behavioural sciences, and the Alexandria and Bernard Schoninger endowed chair for memory disorders at the University of Miami Miller School of Medicine. read more

    He is division chief for cognitive neurology, founding director of the Comprehensive Center for Brain Health, director and principal investigator of the Lewy Body Dementia Research Center of Excellence, and principal investigator for the Native Alzheimer’s Disease Resource Center in Minority Aging Research. 

    Dr Galvin has authored over 375 scientific publications (h-index=73). He is principal investigator on 12 active NIH grants and has received over $120 million in research funding from the National Institutes of Health, Disease Associations, Private and Family Foundations.

    Prof. James Galvin discloses: Consulting fees from Biogen, Bristol Myers Squibb, Cognivue, Eisai, Eli Lilly, GE Healthcare, Lundbeck, Roche and Thema Medical.
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    touchNEUROLOGY touchNEUROLOGY
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    Tutorial

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    Poll

    What potential benefit of new/emerging agents for AAD is most important?

    Submit your answer to see the results

    Increased likelihood of return to non-pharmacological management only
       
    Possibility of personalizing treatment
       
    Targeted symptom control, possibly reducing neurodegeneration
       
    Improved safety profile
       

    Tutorial

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    Poll

    How do you typically monitor the effectiveness of an intervention for AAD?

    Submit your answer to see the results

    Rely on care partner feedback about changes in behaviour
       
    Use a standardized agitation scale (e.g. NPI, CMAI)
       
    Observe the patient during clinic visits for changes in behaviour
       
    A combination of the above
       
     
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    Alzheimer's Disease and Dementia, Neurodegenerative Diseases, Psychiatric Disorders CE/CME accredited

    touchPANEL DISCUSSION
    A visually engaging discussion designed to emulate a ‘live’ panel experience and provide clinicians with practical expert insights to address their clinical challenges. Useful tips below will show how to navigate the activity. Close

    Pharmacological management of agitation in Alzheimer’s dementia: Rationale and evidence for new and emerging treatment options

    Faculty Podcast Featured
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    Learning Objectives

    After watching this activity, participants should be better able to:

    • Outline best practice strategies to manage agitation in patients with Alzheimer's dementia, including psychosocial care and pharmacological treatment options
    • Explain the pathophysiology of agitation in Alzheimer's dementia and the rationale for new and emerging pharmacological treatment approaches
    • Evaluate evidence for new and emerging pharmacological therapies for treating agitation in Alzheimer's dementia
    Overview

    In this activity, three experts consider best practice in the management of agitation in Alzheimer’s dementia and the potential of new pharmacological approaches that target aspects of the underlying pathophysiology. The discussion is guided by pre-canvassed questions provided by healthcare professionals involved in the management of people living with dementia associated with Alzheimer’s disease.

    This activity is jointly provided by USF Health and touchIME in collaboration with the Gerontological Society of America (GSA). read more

    Target Audience

    This activity has been designed to meet the educational needs of Alzheimer’s disease specialists, neurologists, psychiatrists, primary care physicians, specialist nurse practitioners and physician assistants involved in the management of people living with dementia associated with Alzheimer’s disease.

    Disclosures

    USF Health adheres to the Standards for Integrity and Independence in Accredited Continuing Education. All individuals in a position to influence content have disclosed to USF Health any financial relationship with an ineligible organization. USF Health has reviewed and mitigated all relevant financial relationships related to the content of the activity. The relevant relationships are listed below. All individuals not listed have no relevant financial relationships.

    Faculty

    Prof. Jeffrey Cummings discloses: Advisory board or panel fees from Acadia, Biogen, Genentech, Grifols, Janssen, Karuna, Otsuka, ReMYND, Roche and Signant Health. Consulting fees from Acadia, Acumen, ALZpath, Artery, Biogen, Biohaven, Bristol Myers Squibb, Eisai, Eli Lilly, EQT Life Sciences (formerly LSP), Fosun, GAP Foundation, Janssen, Karuna, Kinoxis, Lighthouse, Lundbeck, Merck, MoCA Cognition, New Amsterdam Pharma, Novo Nordisk, Optoceutics, Otsuka, Oxford Brain Diagnostics, Praxis, Prothena, ReMYND, Roche, Scottish Brain Sciences, Signant Health, Simcere, Sinaptica, TrueBinding and Vaxxinity. Grants/research support from the National Institute of General Medical Sciences and the National Institute on Aging. Other financial or material support from Neuropsychiatric Inventory (NPI) copyright. Stock/shareholder (self-managed) from Acumen, Alzheon, Artery, Behrens, MedAvante-Prophase and Vaxxinity.

    Prof. Krista Lanctôt discloses: Advisory board or panel fees from Bright Minds, Exciva, Lundbeck, Novo Nordisk and Otsuka. Consulting fees from Bristol Myers Squibb, Cerevel Therapeutics, Exciva, Ironshore Pharma, Kondor Pharma (relationship terminated) and Praxis Therapeutics. Grants/research support from Cerevel Therapeutics. Speaker Bureau fees from Eisai Co., Ltd, Lundbeck and Novo Nordisk (all relationships terminated).

    Prof. James Galvin discloses: Consulting fees from Biogen, Bristol Myers Squibb, Cognivue, Eisai, Eli Lilly, GE Healthcare, Lundbeck, Roche and Thema Medical.

    Touch Medical Contributors

    Christina Mackins-Crabtree has no financial interests/relationships or affiliations in relation to this activity.

    USF Health Office of Continuing Professional Development and touchIME staff have no financial interests/relationships or affiliations in relation to this activity.

    Requirements for Successful Completion

    In order to receive credit for this activity, participants must review the content and complete the post-test and evaluation form. Statements of credit are awarded upon successful completion of the post-test and evaluation form.

    If you have questions regarding credit please contact cpdsupport@usf.edu 

    Accreditations

    Physicians

    This activity has been planned and implemented in accordance with the accreditation requirements and policies of the Accreditation Council for Continuing Medical Education (ACCME) through a joint providership of USF Health and touchIME. USF Health is accredited by the ACCME to provide continuing medical education for physicians.

    USF Health designates this enduring material for a maximum of 0.75 AMA PRA Category 1 CreditTM. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

    Advanced Practice Providers

    Physician Assistants may claim a maximum of 0.75 Category 1 credits for completing this activity. NCCPA accepts AMA PRA Category 1 CreditTM from organizations accredited by ACCME or a recognized state medical society.

    The AANPCP accepts certificates of participation for educational activities approved for AMA PRA Category 1 CreditTM by ACCME-accredited providers. APRNs who participate will receive a certificate of completion commensurate with the extent of their participation.

    Date of original release: 30 October 2024. Date credits expire: 30 October 2025.

    If you have any questions regarding credit, please contact cpdsupport@usf.edu

     

     

    This activity is CE/CME accredited

    To obtain the CE/CME credit(s) from this activity, please complete this post-activity test.

    Claim Credit
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    Topics covered in this activity

    Alzheimer's Disease and Dementia / Neurodegenerative Diseases / Psychiatric Disorders
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    This activity is funded by:

    An independent medical education grant from Lundbeck. This activity is jointly provided by USF Health and touchIME in collaboration with the Gerontological Society of America (GSA).

    The information provided by this CME activity is for continuing education purposes only and is not meant to substitute for the independent medical/clinical judgement of a healthcare provider relative to diagnostic and treatment options of a specific patient’s medical condition.

    USF is an Equal Opportunity / Affirmative Action / Equal Access Institution.

    USF Health is accredited by the Accreditation Council for Continuing Medical Education, the American Nurses Credentialing Center and the Accreditation Council for Pharmacy Education to provide continuing education to healthcare professionals. As an accredited provider, USF Health is required to disclose personal information to relevant accredited bodies that certify CME to process credits/contact hours, comply with reporting requirements, and for internal recordkeeping and regulatory purposes. USF Health does not share or sell any individual’s contact information or unique identifiers to any commercial supporter, advertiser, or third party without the specific permission of the individual.

    Unapproved products or unapproved uses of approved products may be discussed by the faculty; these situations may reflect the approval status in one or more jurisdictions. The presenting faculty have been advised by touchIME and USF Health to ensure that they disclose any such references made to unlabelled or unapproved use. No endorsement by touchIME or USF Health of any unapproved products or unapproved uses is either made or implied by mention of these products or uses in touchIME or USF Health activities. touchIME and USF Health accept no responsibility for errors or omissions.

    This content is intended for healthcare professionals.

    Date of original release: 30 October 2024. Date credits expire: 30 October 2025.

    Claim Credit
    touchPANEL DISCUSSION
    Pharmacological management of agitation in Alzheimer’s dementia: Rationale and evidence for new and emerging treatment options
    0.75 CE/CME credit
    Question 1/5
    Following an inadequate response to multiple psychosocial strategies, you initiate a pharmacological approach to address moderate agitation in your patient with Alzheimer’s dementia. How would you monitor the effectiveness of this intervention?

    Best practice for monitoring pharmacological interventions includes regularly assessing both the effectiveness (reduction in agitation) and the presence of side effects.1 Standardized tools (such as the Neuropsychiatric Inventory) and input from caregivers or family members help gauge overall progress, and medication adjustments should be based on a careful review of these factors over time.1,2

    References

    1. Cummings J, et al. Int Psychogeriatr. 2024;36:251–62.
    2. Sano M, et al. Int Psychogeriatr. 2024;36:238–50.
    Question 2/5
    Asked about the underlying pathophysiology of agitation in Alzheimer's dementia, how would you best describe it?

    Agitation in Alzheimer’s dementia is associated with both neurodegenerative changes and disruptions in neurotransmitter systems.1 Degeneration of the frontal lobe (responsible for behaviour regulation), combined with deficits/dysregulation in neurotransmitters like serotonin and dopamine, leads to behavioural symptoms such as agitation.1,2

    References

    1. Liu KL, et al. Ageing Res Rev. 2018;43:99–107.
    2. Senanarong V, et al. Dement Geriatr Cogn Disord. 2004;17:14–20.
    Question 3/5
    Which of the following statements accurately describes the mechanism or clinical use of new and emerging therapeutics for agitation in Alzheimer's dementia?

    AAD, agitation in Alzheimer’s dementia; SSRI, selective serotonin reuptake inhibitor.

    Nabilone is a cannabinoid receptor type 1 and 2 partial agonist currently under investigation as a potential treatment for AAD through several potential mechanisms, including neuroprotection.1,2     

    Abbreviation

    AAD, agitation in Alzheimer’s dementia.  

    References

    1. Outen JD, et al. Am J Geriatr Psychiatry. 2021;29:1253–63.
    2. Sherman C, et al. Curr Opin Psychiatry. 2018;31:140–6.
    Question 4/5
    Your 88-year-old male patient is showing signs of worsening AAD, despite the use of evidence-based non-pharmacologic approaches for the past 6 months. What approved pharmacologic treatment do you suggest?

    AAD, agitation in Alzheimer’s dementia.

    In May 2023, brexpiprazole was approved by the FDA for the treatment of AAD.1 As of October 2024, it is still the only FDA-approved treatment for AAD. If there is no improvement or worsening of AAD after implementation of evidence-based non-pharmacologic approaches, it is recommended to then consider pharmacologic approaches.2 

     

    Abbreviations

    AAD, agitation in Alzheimer’s dementia; FDA, US Food and Drug Administration. 

    References

    1. FDA news release. Available at: https://bit.ly/3Y8xZJE (accessed 14 October 2024).
    2. Gerontological Society of America. Insights and Implications in Gerontology. August 2023. Available at: https://bit.ly/3HbJQyE (accessed 14 October 2024).
    Question 5/5
    Which of the following best summarizes the efficacy of dextromethorphan-bupropion (AXS-05) in treating agitation in patients with Alzheimer's disease, based on a recent phase III clinical trial?

    CMAI, Cohen-Mansfield Agitation Inventory.

    The phase III ACCORD trial showed that AXS-05 significantly reduced agitation symptoms in patients with Alzheimer’s disease compared with placebo. Significant improvements from baseline in CMAI score were seen in the open-label period (p<0.001), as well as substantially delaying the time to relapse of agitation symptoms compared with placebo in responders during the double-blind period.  

    Abbreviation

    CMAI, Cohen-Mansfield Agitation Inventory. 

    Reference

    Cummings J, et al. Neurology. 2024;102(17 Suppl. 1):PL5.004

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    This activity is funded by:

    An independent medical education grant from Lundbeck. This activity is jointly provided by USF Health and touchIME in collaboration with the Gerontological Society of America (GSA).

    The information provided by this CME activity is for continuing education purposes only and is not meant to substitute for the independent medical/clinical judgement of a healthcare provider relative to diagnostic and treatment options of a specific patient’s medical condition.

    USF is an Equal Opportunity / Affirmative Action / Equal Access Institution.

    USF Health is accredited by the Accreditation Council for Continuing Medical Education, the American Nurses Credentialing Center and the Accreditation Council for Pharmacy Education to provide continuing education to healthcare professionals. As an accredited provider, USF Health is required to disclose personal information to relevant accredited bodies that certify CME to process credits/contact hours, comply with reporting requirements, and for internal recordkeeping and regulatory purposes. USF Health does not share or sell any individual’s contact information or unique identifiers to any commercial supporter, advertiser, or third party without the specific permission of the individual.

    Unapproved products or unapproved uses of approved products may be discussed by the faculty; these situations may reflect the approval status in one or more jurisdictions. The presenting faculty have been advised by touchIME and USF Health to ensure that they disclose any such references made to unlabelled or unapproved use. No endorsement by touchIME or USF Health of any unapproved products or unapproved uses is either made or implied by mention of these products or uses in touchIME or USF Health activities. touchIME and USF Health accept no responsibility for errors or omissions.

    This content is intended for healthcare professionals.

    Date of original release: 30 October 2024. Date credits expire: 30 October 2025.

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