PBT2 可快速改善阿尔茨海默病患者的认知能力:二期试验的附加分析。

PBT2 rapidly improves cognition in Alzheimer's Disease: additional phase II analyses.

机构信息

Mental Health Research Institute, The University of Melbourne, Parkville, VIC, Australia.

出版信息

J Alzheimers Dis. 2010;20(2):509-16. doi: 10.3233/JAD-2010-1390.

Abstract

PBT2 is a copper/zinc ionophore that rapidly restores cognition in mouse models of Alzheimer's disease (AD). A recent Phase IIa double-blind, randomized, placebo-controlled trial found that the 250 mg dose of PBT2 was well-tolerated, significantly lowered cerebrospinal fluid (CSF) levels of amyloid-beta42, and significantly improved executive function on a Neuro-psychological Test Battery (NTB) within 12 weeks of treatment in patients with AD. In the post-hoc analysis reported here, the cognitive, blood marker, and CSF neurochemistry outcomes from the trial were subjected to further analysis. Ranking the responses to treatment after 12 weeks with placebo, PBT2 50 mg, and PBT2 250 mg revealed that the proportions of patients showing improvement on NTB Composite or Executive Factor z-scores were significantly greater in the PBT2 250 mg group than in the placebo group. Receiver-operator characteristic analyses revealed that the probability of an improver at any level coming from the PBT2 250 mg group was significantly greater, compared to placebo, for Composite z-scores (Area Under the Curve [AUC] =0.76, p=0.0007), Executive Factor z-scores (AUC =0.93, p=1.3 x 10(-9)), and near-significant for the ADAS-cog (AUC =0.72, p=0.056). There were no correlations between changes in CSF amyloid-beta or tau species and cognitive changes. These findings further encourage larger-scale testing of PBT2 for AD.

摘要

PBT2 是一种铜/锌离子载体,可迅速恢复阿尔茨海默病(AD)小鼠模型的认知功能。最近的一项 2 期 a 期双盲、随机、安慰剂对照试验发现,250mg 剂量的 PBT2 耐受性良好,显著降低了 AD 患者脑脊液(CSF)中淀粉样蛋白-β42 的水平,并在 12 周的治疗内显著改善了神经心理测试电池(NTB)的执行功能。在此报告的事后分析中,对试验的认知、血液标志物和 CSF 神经化学结果进行了进一步分析。根据 12 周时安慰剂、PBT2 50mg 和 PBT2 250mg 的治疗反应进行排名,发现 PBT2 250mg 组的 NTB 综合或执行因子 z 评分改善的患者比例显著高于安慰剂组。受试者工作特征分析显示,与安慰剂相比,任何水平的改善者从 PBT2 250mg 组出现的概率均显著更高,用于综合 z 评分(曲线下面积 [AUC] =0.76,p=0.0007)、执行因子 z 评分(AUC =0.93,p=1.3 x 10(-9)),ADAS-cog 接近显著(AUC =0.72,p=0.056)。CSF 淀粉样蛋白-β或 tau 种类的变化与认知变化之间没有相关性。这些发现进一步鼓励对 PBT2 进行更大规模的 AD 测试。

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