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Cerebrolysin 治疗轻中度至中度阿尔茨海默病的疗效和安全性:一项随机、双盲、对照试验研究三种剂量 Cerebrolysin 的结果。

Efficacy and safety of Cerebrolysin in moderate to moderately severe Alzheimer's disease: results of a randomized, double-blind, controlled trial investigating three dosages of Cerebrolysin.

机构信息

EuroEspes Biomedical Research Centre, Santa Maria de Babio, 15166 Bergondo, La Coruna, Spain.

出版信息

Eur J Neurol. 2011 Jan;18(1):59-68. doi: 10.1111/j.1468-1331.2010.03092.x.

DOI:10.1111/j.1468-1331.2010.03092.x
PMID:20500802
Abstract

BACKGROUND

cerebrolysin is a neuropeptide preparation mimicking the effects of neurotrophic factors. This subgroup analysis assessed safety and efficacy of Cerebrolysin in patients with moderate to moderately severe Alzheimer's disease (AD) (ITT data set: N = 133; MMSE: 14-20) included in a dose-finding study (ITT data set: N = 51; MMSE: 14-25). Results of the mild AD subgroup (ITT data set: N = 118; MMSE: 21-25) are also presented.

METHODS

patients with AD received 100 ml IV infusions of Cerebrolysin (10, 30 or 60 ml diluted in saline; N = 32, 34 and 35, respectively) or placebo (saline; N = 32) over twelve weeks (5 days per week for 4 weeks and 2 days per week for another 8 weeks). Primary efficacy criteria ADAS-cog+ (Alzheimer's Disease Assessment Scale Cognitive Subpart Modified) and CIBIC+ (Clinical Interview-based Impression of Change with Caregiver Input) were assessed 24 weeks after baseline.

RESULTS

at week 24, Cerebrolysin improved the global clinical function significantly with all three dosages and induced significant improvements in cognition, initiation of activities of daily living (ADL) and neuropsychiatric symptoms at 10-, 30- and 60-ml doses, respectively. Treatment effects on total ADL and other secondary parameters (MMSE, Trail-making test) were not significant. Cerebrolysin was safe and well tolerated.

CONCLUSIONS

these results demonstrate the efficacy of Cerebrolysin in moderate to moderately severe AD, showing dose-specific effects similar to those reported for patients with mild to moderate AD. The benefits of Cerebrolysin in advanced AD need to be confirmed in larger trials.

摘要

背景

脑活素是一种模拟神经营养因子作用的神经肽制剂。这项亚组分析评估了脑活素在中度至重度阿尔茨海默病(AD)患者中的安全性和疗效(意向治疗数据集:N = 133;MMSE:14-20),这些患者纳入了一项剂量探索研究(意向治疗数据集:N = 51;MMSE:14-25)。还报告了轻度 AD 亚组(意向治疗数据集:N = 118;MMSE:21-25)的结果。

方法

AD 患者接受 100ml 脑活素静脉输注(10、30 或 60ml 稀释于生理盐水;N = 32、34 和 35)或安慰剂(生理盐水;N = 32),疗程为 12 周(第 1-4 周每周 5 天,第 5-8 周每周 2 天)。在基线后 24 周评估主要疗效标准 ADAS-cog+(阿尔茨海默病评估量表认知分量表改良)和 CIBIC+(基于临床访谈的 caregiver 输入的变化印象)。

结果

在第 24 周,脑活素在所有三个剂量下均显著改善了总体临床功能,并分别在 10ml、30ml 和 60ml 剂量下显著改善了认知、日常生活活动(ADL)的启动和神经精神症状。脑活素对总 ADL 和其他次要参数(MMSE、连线测试)的治疗效果没有显著影响。脑活素安全且耐受良好。

结论

这些结果表明脑活素在中度至重度 AD 中的疗效,显示出与轻度至中度 AD 患者报告的相似的剂量特异性作用。在更大规模的试验中需要证实脑活素在晚期 AD 中的获益。

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