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抗淀粉样蛋白疗法治疗阿尔茨海默病的临床应用前景:来自癌症、风湿病学和神经病学领域的见解

Perspectives on the clinical use of anti-amyloid therapy for the treatment of Alzheimer's disease: Insights from the fields of cancer, rheumatology, and neurology.

作者信息

Jicha Gregory A, Abner Erin L, Coskun Elif P, Huffmyer Mark J, Tucker Thomas C, Nelson Peter T

机构信息

Departments of Internal Medicine, Neurology and Pathology University of Kentucky College of Medicine Lexington Kentucky USA.

The Markey Cancer Center, and the Sanders-Brown Center on Aging University of Kentucky Lexington Kentucky USA.

出版信息

Alzheimers Dement (N Y). 2024 Sep 18;10(3):e12500. doi: 10.1002/trc2.12500. eCollection 2024 Jul-Sep.

Abstract

INTRODUCTION

The advent of disease-modifying therapies for Alzheimer's disease (AD) has raised many questions and debates in the field as to the clinical benefits, risks, and costs of such therapies. The controversies have resulted in the perception that many clinicians are apprehensive about prescribing these medications to their patient populations. There also remains widespread uncertainty as to the economic impact, cost benefit ratio, and safety oversight for use of these medications in standard clinical care settings.

METHODS

To contextualize such issues, the present study compared anti-amyloid biologic therapy (lecanemab) to four commonly used biologic agents in other fields, including trastuzumab for breast cancer, bevacizumab for lung cancer, etanercept for rheumatoid arthritis, and ocrelizumab for multiple sclerosis.

RESULTS

The data presented demonstrate comparable costs, clinical benefits, and risks for these biologic agents in their disparate disease states.

DISCUSSION

These results provide context for the costs, clinical benefits, and safety regarding the mainstream use of anti-amyloid biologic agents for the prevention of cognitive loss. While the era of disease-modifying therapies for AD is now in its infancy, there is an expectation that these discoveries will be followed by improved therapies and combination treatments leading to greater efficacy in ameliorating the clinical trajectory of AD.

HIGHLIGHTS

Anti-amyloid therapy costs are comparable to other commonly used biologics.Anti-amyloid therapy efficacy is comparable to other commonly used biologics.Anti-amyloid therapy safety is compatible with other commonly used biologics.

摘要

引言

用于治疗阿尔茨海默病(AD)的疾病修饰疗法的出现,在该领域引发了许多关于此类疗法的临床益处、风险和成本的问题及争论。这些争议导致人们认为许多临床医生对给患者群体开这些药物心存顾虑。对于这些药物在标准临床护理环境中的经济影响、成本效益比和安全监督,也仍然存在广泛的不确定性。

方法

为了将这些问题置于具体情境中,本研究将抗淀粉样蛋白生物疗法(lecanemab)与其他领域常用的四种生物制剂进行了比较,包括用于乳腺癌的曲妥珠单抗、用于肺癌的贝伐单抗、用于类风湿性关节炎的依那西普以及用于多发性硬化症的奥瑞珠单抗。

结果

所呈现的数据表明,这些生物制剂在不同疾病状态下的成本、临床益处和风险具有可比性。

讨论

这些结果为抗淀粉样蛋白生物制剂预防认知丧失的主流使用的成本、临床益处和安全性提供了背景信息。虽然AD的疾病修饰疗法时代目前尚处于起步阶段,但人们期望这些发现之后会有改进的疗法和联合治疗方法,从而在改善AD的临床进程方面取得更大疗效。

要点

抗淀粉样蛋白疗法的成本与其他常用生物制剂相当。抗淀粉样蛋白疗法的疗效与其他常用生物制剂相当。抗淀粉样蛋白疗法的安全性与其他常用生物制剂相符。

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