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PRIME 长期扩展研究结果:阿杜卡奴单抗的一项随机 1b 期试验。

Results from the long-term extension of PRIME: A randomized Phase 1b trial of aducanumab.

机构信息

Biogen, Cambridge, Massachusetts, USA.

Biogen, Innovation House, Maidenhead, UK.

出版信息

Alzheimers Dement. 2024 May;20(5):3406-3415. doi: 10.1002/alz.13755. Epub 2024 Apr 3.

Abstract

INTRODUCTION

Aducanumab selectively targets aggregated forms of amyloid beta (Aβ), a neuropathological hallmark of Alzheimer's disease (AD).

METHODS

PRIME was a Phase 1b, double-blind, randomized clinical trial of aducanumab. During the 12-month placebo-controlled period, participants with prodromal AD or mild AD dementia were randomized to receive aducanumab or placebo. At week 56, participants could enroll in a long-term extension (LTE), in which all participants received aducanumab. The primary endpoint was safety and tolerability.

RESULTS

Amyloid-related imaging abnormalities-edema (ARIA-E) were the most common adverse event. Dose titration was associated with a decrease in the incidence of ARIA-E. Over 48 months, aducanumab decreased brain amyloid levels in a dose- and time-dependent manner. Exploratory endpoints suggested a continued benefit in the reduction of clinical decline over 48 months.

DISCUSSION

The safety profile of aducanumab remained unchanged in the LTE of PRIME. Amyloid plaque levels continued to decrease in participants treated with aducanumab.

HIGHLIGHTS

PRIME was a Phase 1b, double-blind, randomized clinical trial of aducanumab. We report cumulative safety and 48-month efficacy results from PRIME. Amyloid-related imaging abnormalities-edema (ARIA-E) were the most common adverse event (AE); 61% of participants with ARIA-E were asymptomatic. Dose titration was associated with a decrease in the incidence of ARIA-E. Aducanumab decreased levels of amyloid beta (Aβ) in a dose- and time-dependent manner.

摘要

简介

Aducanumab 选择性靶向淀粉样蛋白 β(Aβ)的聚集形式,这是阿尔茨海默病(AD)的神经病理学标志。

方法

PRIME 是一项 aducanumab 的 1b 期、双盲、随机临床试验。在为期 12 个月的安慰剂对照期内,前驱 AD 或轻度 AD 痴呆患者被随机分配接受 aducanumab 或安慰剂。在第 56 周,参与者可以参加长期扩展(LTE),所有参与者都接受 aducanumab 治疗。主要终点是安全性和耐受性。

结果

淀粉样相关成像异常-水肿(ARIA-E)是最常见的不良事件。剂量滴定与 ARIA-E 发生率的降低相关。在 48 个月内,aducanumab 以剂量和时间依赖的方式降低大脑淀粉样蛋白水平。探索性终点表明,在 48 个月内,临床下降的减少仍有持续获益。

讨论

PRIME 的 LTE 中,aducanumab 的安全性状况保持不变。接受 aducanumab 治疗的参与者的淀粉样斑块水平继续下降。

重点

PRIME 是一项 aducanumab 的 1b 期、双盲、随机临床试验。我们报告了 PRIME 的累积安全性和 48 个月疗效结果。淀粉样相关成像异常-水肿(ARIA-E)是最常见的不良事件(AE);61%的 ARIA-E 患者无症状。剂量滴定与 ARIA-E 发生率的降低相关。Aducanumab 以剂量和时间依赖的方式降低淀粉样蛋白 β(Aβ)水平。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9f1c/11095417/35d75ae169ae/ALZ-20-3406-g001.jpg

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