Safety and Efficacy of Anti-Amyloid-β Immunotherapy in Alzheimer's Disease: A Systematic Review and Meta-Analysis.

IF 5.2 3区医学 Q1 NEUROSCIENCES

Journal of Neuroimmune Pharmacology Pub Date : 2017-03-01 Epub Date: 2016-12-26 DOI:10.1007/s11481-016-9722-5

Ross Penninkilampi, Holly M Brothers, Guy D Eslick

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引用次数: 0

Abstract

Immunotherapeutics targeting amyloid-β (Aβ) have had mixed results in clinical trials. The present study aims to evaluate the safety and clinical efficacy of immunotherapeutic agents targeting Aβ in Alzheimer's disease. Randomised controlled trials of at least two weeks duration were included in the review. Fourteen randomised controlled trials (n = 5554) were identified in a systematic search of eight electronic databases. Upon pooling of data, there was no increased risk of any adverse event, serious adverse events, or death with the exception of a near fivefold increase in amyloid-related imaging abnormalities (ARIA; OR 4.79, 95% CI 1.24-18.55; p = 0.02). Of the cognitive indicators, the Mini-Mental State Examination (MMSE) showed a small statistically significant improvement (diff in means =0.44; p = 0.02), while the others (ADAS-cog, ADCS-ADL, and CDR-sb) showed no change. Therefore, immunotherapeutic agents have been relatively well tolerated, with some promise for cognitive improvements if the occurrence of ARIA can be mitigated.

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抗β淀粉样蛋白免疫疗法治疗阿尔茨海默病的安全性和有效性:一项系统综述和荟萃分析

针对淀粉样蛋白-β (Aβ)的免疫疗法在临床试验中有不同的结果。本研究旨在评价靶向Aβ免疫治疗药物治疗阿尔茨海默病的安全性和临床疗效。至少持续两周的随机对照试验被纳入本综述。系统检索了8个电子数据库，确定了14个随机对照试验（n = 5554）。汇总数据后，除了淀粉样蛋白相关成像异常增加近5倍外，任何不良事件、严重不良事件或死亡的风险均未增加(ARIA；Or 4.79, 95% ci 1.24-18.55；p = 0.02)。在认知指标中，简易精神状态检查（MMSE）显示有统计学意义的轻微改善(平均差异=0.44；p = 0.02)，其他指标ADAS-cog、ADCS-ADL、CDR-sb无变化。因此，免疫治疗药物的耐受性相对较好，如果可以减轻ARIA的发生，则有可能改善认知能力。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Journal of Neuroimmune Pharmacology 医学-神经科学

CiteScore

13.60

自引率

0.00%

发文量

审稿时长

6-12 weeks

期刊介绍： The aims of the Journal of Neuroimmune Pharmacology are to promote the dissemination, interest, and exchange of new and important discoveries for the pharmacology and immunology of the nervous system. The aims parallel that of the Society on NeuroImmune Pharmacology by increasing the fundamental understanding of neurologic and neuropsychiatric disorders affected by the immune system or vice versa and towards pharmacologic measures that lead, either to a better understanding of disease mechanisms, or by improving disease outcomes. The scope of JNIP includes all primary works and reviews into the etiology, prevention, and treatment of neuroimmune and nervous system diseases affected by disordered immunity. Original studies serving to define neuroimmune modulation of environmental or endogenous cues such as toxins and drugs of abuse, hormones, and cytokines are welcome. JNIP will serve as a reliable source of interdisciplinary information bridging the fields of pharmacology, immunology, and neuroscience.