在早期阿尔茨海默氏症中,TREM2主动抗体AL002:第二阶段随机试验
Catherine J Mummery1, Arthur J Mayorga2, Adam Simmons2
1Dementia Research Centre, National Hospital for Neurology and Neurosurgery, University College London Hospital, London, UK.
Nature medicine
|March 5, 2026
概括
在早期阿尔茨海默氏症 (AD) 中对TREM2激动性抗体AL002的试验没有达到其主要目标. 虽然显示了目标参与,但AL002与安慰剂相比没有显著改善认知功能.
科学领域:
- 神经科学是一个神经科学.
- 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:
- 在骨髓细胞2 (TREM2) 上表达的触发受体对微质功能至关重要,并与阿尔茨海默氏症 (AD) 病原发生有关.
- TREM2调制是AD等神经退行性疾病的潜在治疗策略.
研究的目的:
- 为了评估AL002的安全性和有效性,TREM2主动性单克隆抗体,在早期AD的参与者中.
- 评估AL002对认知衰退和AD生物标志物的影响.
主要方法:
- 一个2期,随机,双盲,安慰剂对照试验,涉及381名早期AD参与者.
- 参与者每4周内接受静脉注射AL002 (15,40或60毫克/公斤) 或安慰剂,持续48-96周.
- 通过大脑脊髓液 (CSF) 溶解的TREM2和骨质疏松素水平评估目标参与,并使用临床痴呆症评分-盒子总和 (CDR-SB) 评分来评估认知结果.
主要成果:
- AL002在中枢神经系统中表现出持续的目标参与和药理动力学效应.
- 该研究没有达到其主要终点,在96周AL002和安慰剂组之间的CDR-SB得分变化没有显著差异.
- 最常见的不良事件是磁共振成像 (MRI) 变化与粉样蛋白相关成像异常 (ARIA) 相一致.
结论:
- 在AD早期对TREM2激动性抗体的首次试验对认知终点呈负面结果.
- AL002显示了目标参与,但在这个早期的AD人群中没有提供临床益处.
- 这些发现为TREM2疗法和AD临床试验中ARIA的发生提供了宝贵的见解.
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