公共卫生 公共卫生
Alison J O'Donnell1,2, Xinhua Zhao1,3, Alyssa Parr1
1VA Pittsburgh Healthcare System, Pittsburgh, PA, USA.
Alzheimer's & dementia : the journal of the Alzheimer's Association
|December 23, 2025
概括
在退伍军人中使用lecanemab的现实世界显示,25%的退伍军人经历了与粉样蛋白相关的成像异常或中风. 长期监测对于莱卡尼马布在阿尔茨海默病治疗中的安全性和有效性至关重要.
科学领域:
- 神经学 神经学
- 药理学 药理学是指药理学的学科.
- 老年病的医生 老年病的医生
背景情况:
- 莱卡内马布是一种抗粉样类单克隆抗体,在2023年在退伍军人卫生管理局 (VHA) 批准用于阿尔茨海默病 (AD) 治疗.
- 关于lecanemab在VHA中的使用情况和患者结果的现实数据仍然有限.
研究的目的:
- 评估lecanemab在退伍军人群中的初始现实世界的使用,安全性和有效性.
- 评估结果,包括药物坚持,认知变化以及ARIA和中风等不良事件.
主要方法:
- 对2023年10月至2024年9月期间开始使用lecanemab的退伍军人进行回顾性队列研究.
- 从VA企业数据仓库提取的数据,并补充了人口统计,认知分数 (MoCA),APOE基因型和神经成像的图表审查.
- 分析包括药物坚持,MRI发现,6个月后的MoCA变化,ARIA发生率和医疗保健利用率.
主要成果:
- 32名退伍军人 (平均年龄75岁,100%男性,97%白人) 开始接受lecanemab治疗,53%的退伍军人有轻度认知障碍,47%的退伍军人有轻度痴呆.
- 25%的人经历了成像异常,其中2人 (6.2%) 患有急性中风,6人 (18.8%) 患有ARIA (水/出血).
- 只有32%的6个月随访的患者完成了MoCA,平均变化为-0.2.2. 三名患者因ARIA,副作用或偏好而停止治疗.
结论:
- 在VHA的初始lecanemab使用集中在白人,男性,城市居住的退伍军人中.
- 25%的ARIA或中风发病率凸显了警安全监测和莱卡尼马布长期有效性评估的急需.
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