在早期阿尔茨海默氏症患者中进行了两项Gantenerumab第三期试验
Randall J Bateman1, Janice Smith1, Michael C Donohue1
1From the Department of Neurology, Washington University School of Medicine, St. Louis (R.J.B.); Roche Products, Welwyn Garden City (J.S., C.L.), and the Department of Brain Sciences, Faculty of Medicine, Imperial College London (R.J.P.), and the Dementia Research Centre, Department of Neurodegenerative Disease, and the U.K. Dementia Research Institute, Queen Square Institute of Neurology, University College London (N.C.F.), London - all in the United Kingdom; the Alzheimer's Therapeutic Research Institute, Keck School of Medicine, University of Southern California, San Diego (M.C.D.), and Genentech, South San Francisco (T.B., R.S.D.) - both in California; F. Hoffmann-La Roche, Basel, Switzerland (P.D., R.A., J.W., T.B., G.K., A. Thanasopoulou, M. Baudler, P.F., R.S.D.); Butler Hospital and Warren Alpert Medical School, Brown University, Providence, RI (S.S.); the Department of Psychiatry and Neurochemistry, Sahlgrenska Academy, University of Gothenburg, and the Clinical Neurochemistry Laboratory, Sahlgrenska University Hospital - both in Mölndal, Sweden (K.B.); the Division of Neurology, Department of Medicine, Sunnybrook Health Sciences Centre, and the L.C. Campbell Cognitive Neurology Research Unit, Dr. Sandra Black Centre for Brain Resilience and Recovery, Hurvitz Brain Sciences Research Program, Sunnybrook Research Institute, University of Toronto - both in Toronto (S.E.B.); the Ace Alzheimer Center Barcelona, Universitat Internacional de Catalunya, Barcelona, and the Networking Research Center on Neurodegenerative Diseases (CIBERNED), Instituto de Salud Carlos III, Madrid - both in Spain (M. Boada); the Department of Psychiatry and Psychotherapy, Klinikum rechts der Isar, School of Medicine, Technical University of Munich, Munich, Germany (T.G.); the Department of Neurology, Faculty of Medicine, University of Tsukuba, Tsukuba, Japan (A. Tamaoka); the Department of Neurology, Georgetown University School of Medicine, Washington, DC (R.S.T.); the Alzheimer's Research and Treatment Center, Wellington, FL (D.W.); the Medical and Cognitive Research Unit, Heidelberg Repatriation Hospital, Austin Health, Melbourne, VIC, Australia (M.W.); and the Chambers-Grundy Center for Transformative Neuroscience, Department of Brain Health, School of Integrated Health Sciences, University of Nevada, Las Vegas, Las Vegas (J.L.C.).
在阿尔茨海默氏症早期,甘鲁马布减少了粉样质斑块,但并没有减缓认知能力的下降. 这种单克隆抗体向beta-粉样蛋白,显示斑块减少,但在试验中没有显著的临床益处.
科学领域:
- 神经学 神经学
- 免疫治疗是一种免疫疗法.
- 阿尔茨海默氏症疾病研究研究
背景情况:
- 针对粉样β (Aβ) 的单克隆抗体显示出减缓阿尔茨海默病进展的潜力.
- 甘努马布是一种全人类抗AβIgG1抗体,向聚合Aβ,并已被研究用于阿尔茨海默氏症的治疗.
研究的目的:
- 评估甘鲁马布在减缓早期阿尔茨海默氏症认知和功能衰退方面的疗效.
- 在两个第三阶段试验中评估甘鲁马布对粉样斑块负担和临床结果的影响.
主要方法:
- 两个随机的,安慰剂对照的第3期试验 (GRADUATE I和II) 招募了50-90岁的参与者,他们患有早期阿尔茨海默病和粉样蛋白斑块.
- 参与者每隔两周内静脉注射甘鲁马布或安慰剂,主要结果是116周临床痴呆症评分表-盒子总和 (CDR-SB) 评分的变化.
主要成果:
- 与安慰剂相比,Gantenerumab治疗导致粉样质斑块负担显著降低,通过PET扫描测量.
- 在116周后,Gantenerumab和安慰剂组之间没有观察到主要结局 (CDR-SB得分的变化) 的显著差异.
- 与有关的粉样蛋白相关的成像异常 (ARIA-E) 在接受甘鲁马布的参与者中发生了24.9%,其中5.0%出现了症状的ARIA-E.
结论:
- 在116周的阿尔茨海默氏症早期患者中,甘鲁马布有效地降低了粉样斑块负担.
- 尽管减少了粉样蛋白斑块,但甘鲁马布与研究群体的临床衰退显著减缓无关.
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