Greenberg Steven M, Aparicio Hugo J, Furie Karen L, Goyal Manu S, Hinman Jason D, Kozberg Mariel, Leonard Anne, Fisher Mark J
Stroke. 2025 Jan;56(1):e30-e38. doi: 10.1161/STR.0000000000000480. Epub 2024 Dec 11.
Antibodies directed at the amyloid-β peptide offer the prospect of disease-modifying therapy for early-stage Alzheimer disease but also carry the risk of brain edema or bleeding events, collectively designated amyloid-related imaging abnormalities. Introduction of the antiamyloid immunotherapies into practice is therefore likely to present a new set of questions for clinicians treating patients with cerebrovascular disease: Which manifestations of cerebrovascular disease should preclude, or permit, antibody treatment? Is it safe to prescribe amyloid immunotherapies to individuals who require antithrombotic treatment, or to administer thrombolysis to antibody-treated individuals with acute stroke? How should severe amyloid-related imaging abnormalities be managed? This science advisory summarizes the data and key considerations to guide these challenging decisions as the medical community collects further data and experience with these groundbreaking agents.
针对淀粉样β肽的抗体为早期阿尔茨海默病提供了疾病修饰治疗的前景，但也存在脑水肿或出血事件的风险，统称为淀粉样相关成像异常。因此，将抗淀粉样蛋白免疫疗法应用于临床实践可能会给治疗脑血管疾病患者的临床医生带来一系列新问题：哪些脑血管疾病表现应排除或允许使用抗体治疗？给需要抗血栓治疗的个体开淀粉样蛋白免疫疗法是否安全，或者给接受抗体治疗的急性中风个体进行溶栓治疗是否安全？如何处理严重的淀粉样相关成像异常？本科学咨询总结了相关数据和关键考虑因素，以指导这些具有挑战性的决策，因为医学界正在收集关于这些开创性药物的更多数据和经验。
