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额颞叶变性的药物研发优势(额颞叶变性系列之三:下一个治疗前沿)。

The advantages of frontotemporal degeneration drug development (part 2 of frontotemporal degeneration: the next therapeutic frontier).

机构信息

Memory and Aging Center, Department of Neurology, University of California, San Francisco, CA, USA.

出版信息

Alzheimers Dement. 2013 Mar;9(2):189-98. doi: 10.1016/j.jalz.2012.03.003. Epub 2012 Oct 10.

Abstract

Frontotemporal degeneration (FTD) encompasses a spectrum of related neurodegenerative disorders with behavioral, language, and motor phenotypes for which there are currently no effective therapies. This is the second of two articles that summarize the presentations and discussions that occurred at two symposia in 2011 sponsored by the Frontotemporal Degeneration Treatment Study Group, a collaborative group of academic and industry researchers that is devoted to developing treatments for FTD. This article discusses the current status of FTD clinical research that is relevant to the conduct of clinical trials, and why FTD research may be an attractive pathway for developing therapies for neurodegenerative disorders. The clinical and molecular features of FTD, including rapid disease progression and relatively pure molecular pathology, suggest that there are advantages to developing drugs for FTD as compared with other dementias. FTD qualifies as orphan indication, providing additional advantages for drug development. Two recent sets of consensus diagnostic criteria will facilitate the identification of patients with FTD, and a variety of neuropsychological, functional, and behavioral scales have been shown to be sensitive to disease progression. Moreover, quantitative neuroimaging measurements demonstrate progressive brain atrophy in FTD at rates that may surpass Alzheimer's disease. Finally, the similarities between FTD and other neurodegenerative diseases with drug development efforts already underway suggest that FTD researchers will be able to draw on this experience to create a road map for FTD drug development. We conclude that FTD research has reached sufficient maturity to pursue clinical development of specific FTD therapies.

摘要

额颞叶变性(FTD)包含一系列相关的神经退行性疾病,具有行为、语言和运动表型,目前尚无有效的治疗方法。这是两篇综述文章中的第二篇,总结了 2011 年由额颞叶变性治疗研究小组(一个致力于开发 FTD 治疗方法的学术和行业研究人员合作小组)赞助的两个专题讨论会的演示和讨论。本文讨论了与临床试验实施相关的当前 FTD 临床研究现状,以及为什么 FTD 研究可能是开发神经退行性疾病治疗方法的一个有吸引力的途径。FTD 的临床和分子特征,包括疾病的快速进展和相对纯粹的分子病理学,表明与其他痴呆症相比,开发 FTD 药物具有优势。FTD 符合孤儿病指征,为药物开发提供了额外的优势。最近的两套共识诊断标准将有助于识别 FTD 患者,并且已经证明各种神经心理学、功能和行为量表对疾病进展敏感。此外,定量神经影像学测量显示 FTD 患者的大脑萎缩速度可能超过阿尔茨海默病。最后,FTD 与其他已经开展药物开发工作的神经退行性疾病之间的相似性表明,FTD 研究人员将能够借鉴这些经验为 FTD 药物开发制定路线图。我们得出结论,FTD 研究已经达到了足够的成熟度,可以进行特定的 FTD 治疗的临床开发。

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