公共卫生 公共卫生
Marwan N Sabbagh1, Sharon Cohen2, Ashley Holub3
1Barrow Neurological Institute, Phoenix, AZ, USA.
Alzheimer's & dementia : the journal of the Alzheimer's Association
|December 23, 2025
概括
与donanemab相比,lecanemab显示ARIA (与粉样蛋白相关的成像异常) 的风险明显较低. 这包括降低ARIA-E,ARIA-H和相关死亡风险,特别是在APOE4载体中.
科学领域:
- 神经学 神经学
- 药理学 药理学是指药理学的学科.
- 临床试验 临床试验
背景情况:
- 阿尔茨海默病的治疗方法,包括像lecanemab和donanemab这样的抗粉样单克隆抗体,显示出不同的安全性.
- 了解这些差异对于患者护理和治疗选择至关重要.
研究的目的:
- 进行lecanemab和donanemab的间接治疗比较 (ITC).
- 评估和比较这两种抗粉样蛋白疗法之间的安全结果,特别是ARIA (粉样蛋白相关的成像异常) 和死亡.
主要方法:
- 从FDA标签,审查文件和出版物中使用ARIA率的间接治疗比较 (ITC).
- 使用安慰剂作为常见比较剂,比较lecanemab和donanemab,分析ARIA-E,ARIA-H,脑内出血 (ICH) 和18个月的死亡.
- 雇员定了布切尔ITC和风险差异差异 (RDD) 分析以评估治疗效应.
主要成果:
- 与多纳尼马布 (RDD: -10.1%) 相比,勒卡涅马布显示任何ARIA (ARIA-E或ARIA-H) 的风险明显较低.
- 随着lecanemab的使用,ARIA-E (-10.7%) 和ARIA-H (-10.1%) 的显著减少被观察到,在APOE4载体中持续存在.
- 莱卡内马布显示出较低的微出血和表面 siderosis 的风险; ICH 和全因死亡没有显著差异,但莱卡内马布与同时发生的 ARIA 或 ICH 死亡风险较低.
结论:
- 与donanemab相比,lecanemab对ARIA结果的风险明显较低,包括与ARIA或ICH相关的死亡.
- 这些发现凸显了两种抗粉样蛋白疗法之间的独特安全性.
- 需要进一步的现实研究来为临床决策提供有关比较安全性的信息.
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