Brown Medical School, Butler Hospital, Providence, RI, USA.
Center for Alzheimer Research and Treatment, Brigham and Women's Hospital, MA, USA.
J Alzheimers Dis. 2018;64(3):689-707. doi: 10.3233/JAD-171157.
A 3-year extension of two Phase III parent studies of intravenous (IV) bapineuzumab in patients with mild-to-moderate Alzheimer's disease dementia (apolipoprotein (APOE) ɛ4 carriers and noncarriers) is summarized.
The primary and secondary objectives were to evaluate the long-term safety, tolerability, and maintenance of efficacy of bapineuzumab.
A multicenter study in patients who had participated in double-blind placebo-controlled parent studies. Patients enrolled in the extension study were assigned to receive IV infusions of bapineuzumab (0.5 or 1.0 mg/kg) every 13 weeks until termination but were blinded to whether they had received bapineuzumab or placebo in the parent studies.
A total of 1,462 (688 were APOEɛ4 carriers and 774 were noncarriers) patients were enrolled. Extension-onset adverse events occurred in >81% of the patients in each dose group. Fall, urinary tract infection, agitation, and ARIA-E occurred in ≥10% of participants. The incidence proportion of ARIA-E was higher among carriers and noncarriers who received bapineuzumab for the first time in the extension study (11.8% and 5.4%, respectively) versus those who were previously exposed in the parent studies (5.1% and 1.3%, respectively). After 6 to 12 months exposure to bapineuzumab IV in the extension study, similar deterioration of cognition and function occurred with no significant differences between the dose groups.
Infusion of bapineuzumab 0.5 or 1.0 mg/kg every 13 weeks for up to 3 years was generally well tolerated, with a safety and tolerability profile similar to that in previous studies.
静脉注射(IV)bapineuzumab 在轻度至中度阿尔茨海默病痴呆(载脂蛋白(APOE)ɛ4 携带者和非携带者)的两项 III 期母体研究的 3 年延长中进行了总结。
主要和次要目标是评估 bapineuzumab 的长期安全性、耐受性和疗效维持。
一项在参与双盲安慰剂对照母体研究的患者中进行的多中心研究。入组扩展研究的患者被分配接受 IV 输注 bapineuzumab(0.5 或 1.0 mg/kg),每 13 周一次,直至终止,但对他们在母体研究中接受 bapineuzumab 或安慰剂的情况保持盲态。
共有 1462 名(688 名是 APOEɛ4 携带者,774 名是非携带者)患者入组。每个剂量组中超过 81%的患者出现了扩展期不良事件。跌倒、尿路感染、激越和 ARIA-E 在≥10%的参与者中发生。在扩展研究中首次接受 bapineuzumab 治疗的携带者和非携带者中,ARIA-E 的发生率比例较高(分别为 11.8%和 5.4%),而在母体研究中之前暴露的患者中,发生率比例分别为 5.1%和 1.3%。在扩展研究中接受 bapineuzumab IV 治疗 6 至 12 个月后,认知和功能的恶化情况相似,两组之间无显著差异。
每 13 周静脉输注 bapineuzumab 0.5 或 1.0 mg/kg,最长可达 3 年,总体耐受性良好,安全性和耐受性与之前的研究相似。