Abdelnour Carla, Gonzalez Maria Camila, Gibson Lucy L, Poston Kathleen L, Ballard Clive G, Cummings Jeffrey L, Aarsland Dag
Department of Neurology and Neurological Sciences, Stanford University School of Medicine, Stanford, CA, USA.
Department of Quality and Health Technology, Faculty of Health Sciences, University of Stavanger, Stavanger, Norway.
Neurol Ther. 2023 Jun;12(3):727-749. doi: 10.1007/s40120-023-00467-8. Epub 2023 Apr 5.
Reviews of randomized clinical trials (RCTs) in dementia with Lewy bodies (DLB) are essential for informing ongoing research efforts of symptomatic therapies and potentially disease-modifying therapies (DMTs).
We performed a systematic review of all clinical trials conducted until September 27, 2022, by examining 3 international registries: ClinicalTrials.gov, the European Union Drug Regulating Authorities Clinical Trials Database, and the International Clinical Trials Registry Platform, to identify drugs in trials in DLB.
We found 25 agents in 40 trials assessing symptomatic treatments and DMTs for DLB: 7 phase 3, 31 phase 2, and 2 phase 1 trials. We found an active pipeline for drug development in DLB, with most ongoing clinical trials in phase 2. We identified a recent trend towards including participants at the prodromal stages, although more than half of active clinical trials will enroll mild to moderate dementia patients. Additionally, repurposed agents are frequently tested, representing 65% of clinical trials.
Current challenges in DLB clinical trials include the need for disease-specific outcome measures and biomarkers, and improving representation of global and diverse populations.
对路易体痴呆(DLB)随机临床试验(RCT)的综述对于指导正在进行的症状性治疗和潜在疾病修饰治疗(DMT)的研究工作至关重要。
我们通过查阅3个国际注册库:ClinicalTrials.gov、欧盟药品监管机构临床试验数据库和国际临床试验注册平台,对截至2022年9月27日进行的所有临床试验进行了系统综述,以确定DLB试验中的药物。
我们在40项评估DLB症状性治疗和DMT的试验中发现了25种药物:7项3期试验、31项2期试验和2项1期试验。我们发现DLB有一个活跃的药物研发渠道,大多数正在进行的临床试验处于2期。我们发现最近有将前驱期参与者纳入试验的趋势,尽管超过一半的活跃临床试验将招募轻度至中度痴呆患者。此外,经常对重新利用的药物进行测试,占临床试验的65%。
DLB临床试验当前面临的挑战包括需要针对疾病的结局指标和生物标志物,以及提高全球和多样化人群的代表性。