在阿尔茨海默病中被动抗粉样蛋白β免疫疗法 - - 机遇和挑战
Michael T Heneka1, David Morgan2, Frank Jessen3
1Luxembourg Centre for Systems Biomedicine, University of Luxembourg, Belval, Luxembourg; Departmnet of Medicine, UMass Chan Medical School, Worcester, MA, USA.
Lancet (London, England)
|November 16, 2024
概括
针对β-粉样蛋白的第一个阿尔茨海默病免疫疗法已经出现. 这篇评论涵盖了它们的发展,临床试验以及如何使用它们, 标志着向早期,生物标志物引导的阿尔茨海默氏症痴呆症护理的转变.
科学领域:
- 神经学
- 免疫疗法
- 阿尔茨海默病的研究
背景情况:
- 阿尔茨海默病 (AD) 的发病包括粉样β (Aβ) 斑块.
- 20多年前的临床前研究启动了Aβ导向的被动免疫疗法.
- 改变疾病的抗Aβ免疫疗法的出现标志着阿尔茨海默病治疗的新时代.
研究的目的:
- 审查Aβ定向免疫疗法的致病性基础和临床前数据.
- 讨论aducanumab,lecanemab和donanemab的临床试验结果.
- 概述适当的使用建议,包括患者选择和安全监测.
主要方法:
- 对Aβ定向疫苗治疗的临床前数据和历史发展的回顾.
- 对主要抗粉样蛋白免疫疗法的临床试验结果的分析.
- 检查当前患者选择和安全协议的指南.
主要成果:
- 在临床试验中Aducanumab,lecanemab和donanemab已经显示出有效性.
- 适当使用建议重点关注患者选择和安全性监测.
- 估计有大量患者可能有资格接受治疗, 但医疗保健系统需要调整.
结论:
- 从基于综合症的痴呆症治疗转向以生物标志物为指导的早期阿尔茨海默病治疗,
- 实施这些新疗法需要大量的基础设施和资源调整.
- 早期以生物标志物为指导的治疗有望减缓疾病的进展和延迟痴呆.
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