使用沙库比妥/缬沙坦治疗与阿尔茨海默病风险之间的关系：临床最新进展

IF 7.9 1区医学 Q1 CLINICAL NEUROLOGY

Alzheimer's Research & Therapy Pub Date : 2024-08-01 DOI:10.1186/s13195-024-01547-z

Antoine Garnier-Crussard

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引用次数: 0

摘要

自2014年以来，萨库比特利/缬沙坦（Entresto®）被广泛用于治疗心力衰竭。尽管肾酶抑制剂对心力衰竭有好处，但人们对潜在的淀粉样β（Aβ）积累和阿尔茨海默病（AD）风险的担忧一直存在。本叙述性综述在药物批准十年后对长期服用沙库比妥/缬沙坦的淀粉样病变和神经认知障碍风险进行了评估。临床试验、真实世界研究和药物警戒数据均未表明认知能力下降的风险会增加。在使用沙库比妥/缬沙坦治疗的患者中，血液中的淀粉样蛋白生物标志物显示出干扰，而神经影像生物标志物显示淀粉样蛋白负荷没有显著增加。尽管使用沙库比特利/缬沙坦治疗存在淀粉样蛋白积累和注意力缺失症的理论风险，但目前的临床数据似乎令人欣慰，没有信号表明认知能力下降的风险增加，但血液中基于淀粉样蛋白的生物标志物出现了扰动，这意味着在这种情况下解释生物标志物时要非常谨慎。

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Association between treatment with sacubitril/valsartan and the risk of Alzheimer’s disease: a clinical update

Since 2014, sacubitril/valsartan (Entresto®) is widely prescribed for heart failure. Despite neprilysin inhibition’s benefits in heart failure, concerns about potential amyloid-beta (Aβ) accumulation and Alzheimer’s disease (AD) risk have persisted. This narrative review, a decade post-approval, evaluates the risk of amyloid pathology and neurocognitive disorders in long-term sacubitril/valsartan use. Clinical trials, real-world studies, and pharmacovigilance data do not indicate an increased risk of cognitive decline. In patients treated with sacubitril/valsartan blood-based amyloid biomarkers show perturbations, while neuroimaging biomarkers reveal no significant increase in amyloid load. Despite a theoretical risk of amyloid accumulation and AD under treatment with sacubitril/valsartan, current clinical data appears reassuring, and there is no signal indicating an increased risk of cognitive decline, but a perturbation of amyloid blood-based biomarkers, which implies great caution when interpreting biomarkers in this context.

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来源期刊

Alzheimer's Research & Therapy 医学-神经病学

CiteScore

13.10

自引率

3.30%

发文量

172

审稿时长

>12 weeks

期刊介绍： Alzheimer's Research & Therapy is an international peer-reviewed journal that focuses on translational research into Alzheimer's disease and other neurodegenerative diseases. It publishes open-access basic research, clinical trials, drug discovery and development studies, and epidemiologic studies. The journal also includes reviews, viewpoints, commentaries, debates, and reports. All articles published in Alzheimer's Research & Therapy are included in several reputable databases such as CAS, Current contents, DOAJ, Embase, Journal Citation Reports/Science Edition, MEDLINE, PubMed, PubMed Central, Science Citation Index Expanded (Web of Science) and Scopus.