Cx Precision Medicine’s Alzheimer’s Blood Test Stratifies Patients Early So They Get the Right Care at the Right Time
Under the direction of CEO Danguole Altman and scientist Sid O’Bryant, PhD, CxPM is developing a diagnostic tool that takes the guesswork out of an initial diagnosis of neurodegenerative disease. Their blood test offers a more personalized rule-out of a broad range of conditions, which helps direct care and lower costs.
Challenge
Dr. Sid O’Bryant was practicing as a neuropsychologist when he began to see a troubling trend.
Again and again, primary care physicians would refer patients to him with mild cognitive impairment (MCI) to receive Alzheimer’s testing and care. The problem was that they didn’t have the disease.
It wasn’t the primary care physician’s fault – they were over-extended and understaffed. Plus, there simply weren’t any great tools in the doctor’s toolkit to do any kind of Alzheimer’s diagnosis, let alone a rule-out of other neurodegenerative conditions.
This misdiagnosis and referral was frustrating for O’Bryant, but it was even worse for the patient and their families. After going to their primary care physician with complaints of memory loss or other cognitive decline, they’d waited six to twelve months to see a specialist. That’s a year of worry and uncertainty, only to be told eventually that your problem is something else entirely. This scenario causes pain on the insurance side as well, as payers shell out thousands of dollars for an avoidable specialist visit and the full diagnostic workup associated with that visit.
On the positive side, Alzheimer’s testing is improving. We’re living in an exciting age of new blood-based biomarker tests for Alzheimers’ disease (as we’ve seen recently through StartUp Health’s Alzheimer’s Moonshot). But these tests, even if they were ready for prime time, wouldn’t solve O’Bryant’s problem. That’s because most Alzheimer’s biomarkers currently under development are designed in tandem with a pharmaceutical company’s Alzheimer’s treatment. As a result, they are highly specific to the biological mechanisms relevant to that treatment. In other words, most blood-based Alzheimer’s biomarkers answer a niche question and offer a niche solution.
What if there was a rapid test that could be used at the primary care office that did more than diagnose a specific type of Alzheimer’s. What if it could rule out a series of cognitive pathologies so that the physician could effectively direct the next course of care, saving the patient time and worry, and saving payors thousands of dollars?
That is what Dr. O’Bryant needed most, so he set out to build it himself.
Building Cx Precision Medicine
In a high-tech laboratory at the University of North Texas Health Science Center, O’Bryant studied the subtypes of Alzheimer’s in the hopes of offering a more personalized approach to testing. He wanted to create a tool that could stratify patients and help them know – quickly – what level of care they’d benefit from.
What he and his team developed over time under the name Cx Precision Medicine (the Cx stands for “changing expectations”) was a blood-based test that, instead of focusing on specific proteins like Amyloid and tau, looks at a range of biomarkers like inflammation, metabolic markers, and neurotrophic markers that are present in ethnically diverse patients that are diagnosed with Alzheimer’s based on cognitive testing. They use this broad panel to rule out various brain pathologies.
“This is for patients who need to move further up the care pathway,” says Danguole Altman, who joined the company as CEO in 2020 in order to commercialize what had been developed in the lab. “In that way, we're actually increasing appropriate access and referrals to other more niche tests. These other tests come into play at the secondary level, once an initial assessment has been made.”
Altman brings to the team decades of experience in executive management and drug development. After starting her career at McKinsey, Altman helped run large multi-specialty clinics, and was the CEO of a private-equity-backed physician management company. She went deep into drug commercialization through a stint as CEO of an MD Anderson spinout. Then, through an old colleague she learned about Dr. O’Bryant’s work in Texas, and she was hooked.
“The ability to make an impact in this space is huge,” says Altman. “I’ve spent my career making the healthcare system work better for patients and physicians. We spend a lot of money as a society – more than anywhere else in the world! – but do not have as much to show for it, in terms of health outcomes. I’m excited to work on giving primary care physicians a tool to make their hard job just a bit easier and hopefully help send their patients – who are elderly and scared – on the right diagnostic path so that those patients who ultimately are diagnosed with Alzheimer’s can get treated quickly and spare those without Alzheimer’s from going through a year-long expensive and worry-inducing evaluation if they do not need to.”
Under the Hood
The sweet spot for CxPM’s test is the patient who is 55 years and older visiting their primary care physician with memory complaints. These patients don’t yet have serious symptoms of neurodegeneration and their symptoms may or may not be caused by Alzheimer’s.
CxPM can begin to stratify these patients so that they can take action on their health. By ruling out Alzheimer’s and other related dementias, physicians can focus on identifying the ancillary causes of cognitive decline, like sleep disturbance, depression, long-Covid, medication side effects, etc. Armed with this information, the primary care doctor can do a lot of good and save the patient months of waiting, as well as substantial worry and stress, for a neurological specialist visit.
To accomplish this more holistic testing panel, CxPM uses AI and machine learning to look at a broad array of proteins (21 versus the typical three) and evaluate results with an algorithm trained on an extensive, multi-ethnic database.
CxPM’s test is in the final stages of being approved as a lab-developed test and Altman hopes it will be commercially available in 2025. The next step will be a fundraise and a series of pilots with concierge practices and with payers. They’ve conducted budget impact studies showing the economic savings for payers, and will be rolling those reports out in coming months in order to solidify their reimbursement pathway.
Join us in welcoming Danguole Altman, Dr. Sid O’Bryant, and the Cx Precision Medicine team to StartUp Health’s Alzheimer’s Moonshot.
Connect with Cx Precision Medicine via email
Call for Alzheimer’s Innovation
We’re looking for founders and CEOs leading digital health, life science, or biotech companies that are solving the biggest health challenges of our time. Since we reached our initial Alzheimer’s Moonshot Community goal in just one quarter, we’re opening up 20 new spots through our annual membership program. We’ll officially announce the next group of companies during CTAD in late October, where we will also host a community meetup.
If you’re mission-driven, collaborative, and ready to contribute as much as you gain, you might be the perfect fit. Learn more and apply today.
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Published: Oct 10, 2024