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与粉样蛋白相关的成像异常 (ARIA) 的发展风险因素和临床影响

Sarah J Doran¹, Russell P Sawyer¹

¹Department of Neurology and Rehabilitation Medicine, University of Cincinnati College of Medicine|UC Health, Cincinnati, OH, United States.

Frontiers in neuroscience

|February 5, 2024

概括

新的阿尔茨海默氏症治疗具有ARIA (粉样蛋白相关的成像异常) 等风险. 确定患者的风险因素,如ApoE4状态和之前的中风,对于安全有效的治疗选择至关重要.

科学领域:

神经学神经学
免疫治疗是一种免疫疗法.
临床试验临床试验

背景情况:

阿尔茨海默病 (AD) 影响着数百万人,新的抗粉样蛋白单克隆抗体具有治疗潜力.
这些免疫疗法虽然减缓了病变的进展,但会带来与粉样蛋白相关的成像异常 (ARIA) 的风险,包括 (ARIA-E) 和出血 (ARIA-H).
ARIA可能表现为从轻度到重度的症状,在罕见的情况下甚至导致死亡.

研究的目的:

分析临床试验数据的抗粉样类单克隆抗体 (lecanemab, aducanumab等). ) 的情况.
确定与开发ARIA-E和ARIA-H相关的关键风险因素.
为新兴AD疗法提供患者选择和治疗策略的信息.

主要方法:

对lecanemab, aducanumab, gantenerumab, donanemab 和 bapineuzumab 的临床试验数据的审查和分析.
确定与ARIA发展相关的患者特征和病史.
不同的抗粉样蛋白疗法之间的ARIA发病率的比较.

主要成果:

对ARIA-E的危险因素包括积极的ApoE4载体状态和多次脑微出血.
ARIA-H的危险因素包括年龄较大,使用抗血栓剂,以及以前的中风史.
与阿杜卡努马布相比,莱卡内马布的ARIA-E (12%) 和ARIA-H (17%) 率较低 (35%的ARIA-E,19%的ARIA-H).

结论:

ARIA风险因素显著影响抗粉样蛋白治疗的资格,导致一些诊所的高排斥率.
了解和减轻ARIA风险对于安全使用新的阿尔茨海默病治疗方法至关重要.
需要进一步的研究来完善这些免疫治疗药物的患者选择和管理策略.

关键词:

亚里亚-E 是一个.在ARIA-H中,阿尔茨海默氏症是阿尔茨海默氏症的一种疾病.在 Apoε4 4 的支持下.这是一种抗粉胺的药物.

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