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多纳尼马布:适当使用建议
G D Rabinovici1, D J Selkoe2, S E Schindler3
1Memory & Aging Center, Departments of Neurology, Radiology and Biomedical Imaging, University of California San Francisco, San Francisco, CA, USA.
The journal of prevention of Alzheimer's disease
|March 28, 2025
概括
多纳尼马布已被批准用于早期阿尔茨海默病 (AD). 这些建议指导其在临床实践中的安全和有效使用,重点是患者选择和监测ARIA等副作用.
科学领域:
- 神经学 神经学
- 免疫学 免疫学 免疫学
- 药理学 药理学是指药理学的学科.
背景情况:
- 多纳尼马布是一种已批准的IgG1单克隆抗体,用于早期症状性阿尔茨海默病 (AD).
- 适当使用建议 (AUR) 对于指导donanemab在现实世界中实施至关重要.
- 优先考虑安全性和有效性是患者管理的关键.
研究的目的:
- 为在临床实践中适当使用donanemab制定准则.
- 确定患者适用性标准和donanemab治疗的安全监测协议.
- 整合专家意见和可用的数据,以实现多纳马布的最佳管理.
主要方法:
- 通过共识通过AD和相关疾病治疗工作组开发AUR.
- 整合当前数据和专家临床判断.
- 定义患者个人资料,包括生物标志物确认和排除标准.
主要成果:
- 合适的候选人:轻度认知障碍或轻度痴呆症由于AD (临床阶段3-4,MMSE20-30) 确认AD病理 (PET或CSF).
- 安全考虑:推APOE基因型鉴定;需要MRI预处理;排除标准包括特定的血管发现和微型血液.
- 监测:在特定输注之前和根据临床指示对ARIA进行监测MRI;在粉样蛋白清除后可能中止治疗.
结论:
- 多纳内马布AUR为早期症状AD的安全有效治疗提供了框架.
- 共享决策至关重要,考虑到患者的价值观和护理目标.
- 仔细选择患者,对ARIA进行监测,并考虑粉样蛋白清除率指南的长期管理.
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