Hannestad Jonas, Koborsi Katie, Klutzaritz Vicki, Chao Whitney, Ray Rebecca, Páez Antonio, Jackson Sam, Lohr Scott, Cummings Jeffrey L, Kay Gary, Nikolich Karoly, Braithwaite Steven
Alkahest Inc. San Carlos California USA.
Arcus Biosciences (present affiliation) Hayward California USA.
Alzheimers Dement (N Y). 2020 Dec 16;6(1):e12115. doi: 10.1002/trc2.12115. eCollection 2020.
This phase 2 trial evaluated the safety, tolerability, and feasibility of repeated infusions of the plasma fraction GRF6019 in mild-to-moderate Alzheimer's disease.
In this randomized, double-blind, dose-comparison trial, 47 patients were randomized 1:1 to receive daily infusions of 100 mL (n = 24) or 250 mL (n = 23) of GRF6019 for 5 consecutive days over two dosing periods separated by a treatment-free interval of 3 months.
The mean (standard deviation [SD]) age of the enrolled patients was 74.3 (6.9), and 62% were women. Most adverse events (55%) were mild, with no clinically significant differences in safety or tolerability between the two dose levels. The mean (SD) baseline Mini-Mental State Examination score was 20.6 (3.7) in the 100 mL group and 19.6 (3.7) in the 250 mL group; at 24 weeks, the within-patient mean change from baseline was -1.0 points (95% confidence interval [CI], -3.1 to 1.1) in the 100 mL group and +1.5 points (95% CI, -0.4 to 3.3) in the 250 mL group. The within-patient mean change from baseline on the Alzheimer's Disease Assessment Scale-Cognitive subscale was -0.4 points (95% CI, -2.9 to 2.2) in the 100 mL group, while in the 250 mL group it was -0.9 points (95% CI, -3.0 to 1.2). The within-patient mean change from baseline on the Alzheimer's Disease Cooperative Study-Activities of Daily Living was -0.7 points in the 100 mL group (95% CI, -4.3 to 3.0) and -1.3 points (95% CI, -3.4 to 0.7) in the 250 mL group. The mean change from baseline on the Category Fluency Test, Clinical Dementia Rating Scale-Sum of Boxes, Alzheimer's Disease Cooperative Study-Clinical Global Impression of Change, and Neuropsychiatric Inventory Questionnaire was similar for both treatment groups and did not show any worsening.
GRF6019 was safe and well tolerated, and patients experienced no cognitive decline and minimal functional decline. These results support further development of GRF6019.
本2期试验评估了在轻度至中度阿尔茨海默病患者中重复输注血浆成分GRF6019的安全性、耐受性和可行性。
在这项随机、双盲、剂量比较试验中,47例患者按1:1随机分组,在两个给药周期内连续5天每日输注100 mL(n = 24)或250 mL(n = 23)的GRF6019,两个给药周期之间有3个月的无治疗间隔期。
入组患者的平均(标准差[SD])年龄为74.3(6.9)岁,62%为女性。大多数不良事件(55%)为轻度,两个剂量水平在安全性或耐受性方面无临床显著差异。100 mL组的平均(SD)基线简易精神状态检查表评分为20.6(3.7),250 mL组为19.6(3.7);在24周时,100 mL组患者自基线的平均变化为-1.0分(95%置信区间[CI],-3.1至1.1),250 mL组为+1.5分(95%CI,-0.4至3.3)。100 mL组患者在阿尔茨海默病评估量表-认知分量表上自基线的平均变化为-0.4分(95%CI,-2.9至2.2),而250 mL组为-0.9分(95%CI,-3.0至1.2)。100 mL组患者在阿尔茨海默病协作研究-日常生活活动量表上自基线的平均变化为-0.7分(95%CI,-4.3至3.0),250 mL组为-1.3分(95%CI,-3.4至0.7)。两个治疗组在类别流畅性测试、临床痴呆评定量表-总盒数、阿尔茨海默病协作研究-临床总体变化印象和神经精神科问卷上自基线的平均变化相似,且未显示任何恶化。
GRF6019安全且耐受性良好,患者未出现认知下降且功能下降最小。这些结果支持GRF6019的进一步研发。