在一个专业的记忆诊所治疗lecanemab治疗
Madeline Paczynski1,2, Anna Hofmann1,2, Zachary Posey1
1Department of Neurology, Washington University School of Medicine in St Louis, St Louis, Missouri.
JAMA neurology
|May 12, 2025
概括
在一个记忆诊所治疗早期阿尔茨海默病的Lecanemab治疗显示了可控的输液反应和粉样蛋白相关的成像异常 (ARIA). 大多数不良事件都是轻微的,严重症状的发生率很低,这表明在临床实践中可行性.
科学领域:
- 神经学 神经学
- 药理学 药理学是指药理学的学科.
- 临床医学 临床医学
背景情况:
- 两种单克隆抗体,lecanemab和donanemab,向粉样斑块,已被FDA批准用于早期症状性阿尔茨海默病 (AD).
- 显著的不良事件包括输液相关反应和粉样蛋白相关成像异常 (ARIA),包括胀/输液 (ARIA-E) 和出血/血红素沉积 (ARIA-H).
- 这些治疗方法的临床实践可行性和安全性仍然不清楚.
研究的目的:
- 评估在特殊的记忆诊所环境中使用lecanemab的可行性和安全性.
- 评估早期有症状的阿兹海默症患者与莱卡内马布治疗相关的不良事件的发生率和管理.
主要方法:
- 在2023年8月至2024年10月期间,对234名连续开始接受lecanemab的患者进行了回顾性分析.
- 患者每隔两周内静脉注射10mg/kg的lecanemab.
- 评估输液相关反应,ARIA发展 (ARIA-E和ARIA-H),以及治疗中止.
主要成果:
- 与输液相关的反应发生在37%的患者身上,通常是轻微的.
- 在平均6.5个月的时间里,22%的患者患有ARIA (15%的ARIA-E,6.7%的ARIA-H).
- 症状性ARIA发生在5.7%的患者中,其中1.0%出现严重症状;没有报告的大型出血或死亡. 与轻度认知障碍 (1.8%) 患者相比,轻度痴呆患者的症状性ARIA (27%) 发生率更高.
- 治疗中断发生在9.8%的患者中,其中4.3%是由于ARIA.
结论:
- 在专业记忆诊所设置中启动lecanemab治疗证明了可管理的安全性和可行性.
- 观察到的不良事件率,特别是ARIA,表明这些疗法可以在临床实践中安全地使用.
- 这些发现支持进一步讨论阿尔茨海默病抗粉样蛋白治疗的风险益处概况.
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