摘要
背景:洗礼是一种人源化的抗淀粉样β-β(Aβ)单克隆抗体,旨在降低阿尔茨海默病(AD)患者脑Aβ沉积。 目的:本阶段为开放标签扩展(OLE)研究,旨在评价洗礼治疗轻度至中度AD患者的长期安全性和有效性。 方法:患者(58-78岁),完成两项随机、安慰剂对照、双盲研究(皮下[SC]单剂量递增,或静脉(Iv)多次上升剂量)。进入了奥莱。对三组患者进行了评估:在OLE(洗礼SC/洗礼IV)、研究201和OLE(洗礼/洗礼)中的洗礼(IV)和试验201 a中的洗礼/洗礼(IV),以及研究201 a中的安慰剂(IV)。在OLE(安慰剂/洗礼)中进行第四次洗礼。 结果:194例患者中158例退出OLE,主要原因为受试者(n=85)和AE(n=30)。平均施洗量为2.9(1.90)年。无显着性d受洗/洗礼组与安慰剂/洗礼组的疗效终点(AD评估量表-认知子量表[ADAS-Cog]、痴呆残疾评估[DAD]和MMSE评分)的差异。帕蒂Ents(94.8%,184/194)报告了OLE的≥1治疗-紧急不良事件(TEAES)。22例(11.3%)患者发生与淀粉样蛋白相关的积液或水肿(ARIA-E)异常.最普通的通讯TEAE组(>20%)为跌倒、躁动、尿路感染,与安慰剂/洗礼组相似。 结论:早期治疗组与延迟治疗组认知功能下降差异无显着性(P>0.05)。没有出现新的安全问题。ARIA-E发生率较高。IRST暴露在OLE和以前的洗礼中。没有明确的病因导致死亡事件。
关键词: 阿尔茨海默病,洗礼,MRI,脑淀粉样蛋白相关影像学异常,AD评估量表,痴呆残疾评估。
Current Alzheimer Research
Title:Long-Term Safety and Efficacy of Bapineuzumab in Patients with Mild-to-Moderate Alzheimer’s Disease: A Phase 2, Open-Label Extension Study
Volume: 15 Issue: 13
关键词: 阿尔茨海默病,洗礼,MRI,脑淀粉样蛋白相关影像学异常,AD评估量表,痴呆残疾评估。
摘要: Background: Bapineuzumab is a humanized anti-amyloid-beta (Aβ) monoclonal antibody directed at lowering the cerebral Aβ deposit in Alzheimer’s disease (AD).
Objective:This phase 2, open-label extension (OLE) study evaluated long-term safety and efficacy of bapineuzumab in patients with the mild-to-moderate AD.
Methods: Patients (58-78 years) who completed either of two randomized, placebo-controlled, doubleblind studies (subcutaneous [SC] single-dose-escalation, or intravenous (IV) multiple-ascending-dose)) entered the OLE. Three groups were assessed: bapineuzumab or placebo SC, and bapineuzumab (IV) in OLE (bapi SC/bapi IV); bapineuzumab (IV) in Study 201 and OLE (bapi/bapi); and placebo in Study 201 and bapineuzumab IV in OLE (placebo/bapi).
Results: Of 194 patients enrolled, 158 withdrew from OLE; primarily due to withdrawal by subject (n=85) and AE (n=30). Mean (SD) bapineuzumab exposure was 2.9 (1.90) years. There were no significant differences for efficacy endpoints (AD Assessment Scale–cognitive subscale [ADAS-Cog], Disability Assessment for Dementia [DAD] and MMSE scores) between the bapi/bapi and placebo/bapi groups. Most patients (94.8%, 184/194) reported ≥1 treatment-emergent adverse events (TEAEs) in OLE. Amyloid-related imaging abnormalities with effusion or edema (ARIA-E) occurred in 22 (11.3%) patients. The most common TEAEs (>20% patients) were fall, agitation and urinary tract infection with similar incidences between bapi/bapi and placebo/bapi groups.
Conclusion: No significant difference was seen in cognitive and functional decline between early and delayed treatment groups. No new safety concerns emerged. ARIA-E incidence was higher in patients first exposed to bapineuzumab in OLE versus previously exposed. No clear pattern of etiology contributed to death events.
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Cite this article as:
Long-Term Safety and Efficacy of Bapineuzumab in Patients with Mild-to-Moderate Alzheimer’s Disease: A Phase 2, Open-Label Extension Study, Current Alzheimer Research 2018; 15 (13) . https://dx.doi.org/10.2174/1567205015666180821114813
DOI https://dx.doi.org/10.2174/1567205015666180821114813 |
Print ISSN 1567-2050 |
Publisher Name Bentham Science Publisher |
Online ISSN 1875-5828 |
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