在ADMET 2试验中的冷漠患者对甲基酸的反应异质性
Krista L Lanctôt1, Luc Rivet1, Shankar Tumati1
1Sunnybrook Research Institute (KLL, LR, ST, KS, DV, NH), University of Toronto, Toronto, Ontario, Canada.
甲基胺有效地治疗阿尔茨海默病 (AD) 患者的冷漠. 在没有焦虑或兴奋的人,年轻人,服用胆酶抑制剂的人,具有特定血压的人,以及更大的功能障碍的人中,反应更好.
科学领域:
- 神经科学是一个神经科学.
- 老年学是一门学科.
- 药理学 药理学是指药理学的学科.
背景情况:
- 漠不关心是阿尔茨海默病 (AD) 的常见和致残症状.
- 甲基酸盐在治疗阿尔茨海默病的冷漠症方面已显示出有效性,但反应异质.
- 识别反应的预测因素可以个性化治疗策略.
研究的目的:
- 确定与痴呆相关的冷漠症患者中甲基胺反应的临床预测因素.
- 为了确定哪些患者亚组最有可能从甲基化物治疗中受益.
主要方法:
- 从痴呆症甲基酸盐试验2 (ADMET 2) 的无动于衷的数据分析,这是一个随机的,安慰剂控制的多中心试验.
- 对22个事先选择的临床预测因素进行了单变量和多变量分析.
- 使用神经精神病 inventory apathy domain (NPI-A) 来评估冷漠.
主要成果:
- 甲基胺在治疗冷漠的过程中显示出小到中等的效果大小.
- 甲基酸盐效率更高的预测因素包括缺乏焦虑和激动,处方胆酶抑制剂 (ChEI),年龄在52-72岁之间,透静血压为73-80毫米升,以及更大的功能障碍.
- 这些发现是从177名参与者和6个月的随访数据中得出的.
结论:
- 患有阿尔茨海默氏症和冷漠的年轻患者,不焦虑或激动,处方ChEI,有最佳的透静血压,并表现出更多的功能障碍,更有可能对甲基酸产生反应.
- 甲基化物可以优先考虑对已经在ChEI上并且没有基线焦虑或兴奋的无动于衷的AD患者.
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