Alzheimer's Clinical Trials Across the United States of America: A Cross-Sectional Analysis of Site Distribution and Disease Burden

Lina Petrossian, BS1, Carla Margossian2, Sayler Towsley3, Zella Margossian3, Sarmen Sarkissian, MD3

1School of Medicine, California University of Science and Medicine, Colton, CA, USA
2University at Buffalo, Buffalo, NY, USA
3Armenian American Medical Society, Glendale, CA, USA

INTRODUCTION

Alzheimer’s remains the most common form of dementia nationwide. Participation in clinical trials is critical for the advancement of new treatments. However, equitable access to therapies depends on the geographic distribution of trial sites. Disparities in trial availability can limit participation for patients living in states with high Alzheimer’s mortality, but few research opportunities. According to the CDC, Mississippi has the highest rate of Alzheimer’s mortality. These patterns raise questions about whether the availability of trials aligns with the national burden of disease.

METHODS

We searched ClinicalTrials.gov for interventional Alzheimer’s clinical trials that were looking for participants. Locations were manually extracted from each trial and categorized by state. Using ClinicalTrials.gov, we compiled the total number of sites per city. We generated heatmaps to visually compare site distribution with Alzheimer’s mortality.

RESULTS

A total of 1225 sites from 556 trials were identified across the USA. On a per 100,000 population basis, Mississippi had 0.2 trial sites. <1% of sites were located in Mississippi, despite their disproportionately high Alzheimer’s burden. A chi-square goodness-of-fit test confirmed a statistically significant mismatch between Alzheimer’s mortality and trial site distribution across the nation (p<0.0000001).

CONCLUSIONS

To address the mismatch between disease burden and research opportunities, there is a need to expand Alzheimer’s clinical trials in high-mortality states to ensure that patients in areas most affected by Alzheimer’s have access to interventional therapies.

FIGURES

CONTACT

Lina Petrossian:
lina.petrossian@md.cusm.edu