anti-Alzheimer monoclonal antibody
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Indications
* first beta-amyloid monoclonal antibody to receive traditional approval from the US Food & Drug Administration (FDA)[3]
Contraindications
- anti-Alzheimer beta-amyloid monoclonal antibodies may fail to produce clinically meaningful benefits[6]
- 2 groups of patients not likely to benefit*
- amyloid-negative patients
- amyloid-positive with a high plasma phospho-tau burden
* plasma ptau217 useful for identifying patients unlikely to benefit[5]
Adverse effects
- accelerated ventricular enlargement
- may accelerate brain atrophy*
* all anti-amyloid monoclonal antibodies accelerate brain shrinkage beyond atrophy associated with underlying Alzheimer's disease
* pharmaceutical companies claim that atrophy is evidence of a reduction of amyloid & associated inflammation
- drug adverse effects of anti-Alzheimer monoclonal antibody
- drug adverse effects of pharmaceutical monoclonal antibodies
Laboratory
- plasma p-tau217 outperforms plasma p-tau181 & plasma p-tau231 & other plasma biomarkers of Alzheimer's disease in identifying which patients may benefit from an anti-beta-amyloid anti-Alzheimer monoclonal antibody[5]
Mechanism of action
- pharmaeutical monocloncal antibodies all but semorinemab bind beta-amyloid
- semorinemab binds to N-terminal part of microtubule-associated protein tau
Notes
- CMS announces plan to cover anti-Alzheimer monoclonal antibodies[4]
More general terms
More specific terms
- aducanumab-avwa (Aduhelm)
- Crenezumab
- donanemab (Kisunla)
- gantenerumab
- lecanemab (Leqembi)
- semorinemab (binds MAP-tau)
- solanezumab
Additional terms
References
- ↑ Filippi M, Cecchetti G, Spinelli EG, Vezzulli P, Falini A, Agosta F. Amyloid-Related Imaging Abnormalities and beta-Amyloid-Targeting Antibodies: A Systematic Review JAMA Neurol. 2022 Mar 1;79(3):291-304. PMID: https://www.ncbi.nlm.nih.gov/pubmed/35099507
- ↑ Alves F, Kallinowski P, Ayton S Accelerated Brain Volume Loss Caused by Anti-beta-Amyloid Drugs: A Systematic Review and Meta-analysis. Neurology. 2023. March 27. PMID: https://www.ncbi.nlm.nih.gov/pubmed/36973044 https://n.neurology.org/content/early/2023/03/24/WNL.0000000000207156
- ↑ 3.0 3.1 Rubin R Who Should - and Can - Get Lecanemab, the New Alzheimer Disease Drug? JAMA. Published online September 27, 2023. PMID: https://www.ncbi.nlm.nih.gov/pubmed/37755935 https://jamanetwork.com/journals/jama/fullarticle/2810237
- ↑ 4.0 4.1 CMS.gov June 22, 2023 CMS announces new details of plan to cover new Alzheimer's drugs. https://www.cms.gov/newsroom/fact-sheets/cms-announces-new-details-plan-cover-new-alzheimers-drugs
- ↑ 5.0 5.1 5.2 George J Alzheimer's Blood Test Predicts Who Might Benefit Most From Anti-Amyloid Drugs. Novel two-cutoff approach may reduce need for confirmatory PET scans. MedPage Today December 5, 2023 https://www.medpagetoday.com/neurology/alzheimersdisease/107691
Mattsson-Carlgren N, Collij LE, Stomrud E et al Plasma Biomarker Strategy for Selecting Patients With Alzheimer Disease for Antiamyloid Immunotherapies. JAMA Neurol. Published online December 4, 2023. PMID: https://www.ncbi.nlm.nih.gov/pubmed/38048096 https://jamanetwork.com/journals/jamaneurology/article-abstract/2812432 - ↑ 6.0 6.1 Ebell MH, Barry HC, Baduni K, Grasso G. Clinically Important Benefits and Harms of Monoclonal Antibodies Targeting Amyloid for the Treatment of Alzheimer Disease: A Systematic Review and Meta-Analysis. Ann Fam Med. 2024. 22(1):50-62 PMID: https://www.ncbi.nlm.nih.gov/pubmed/38253509 Free article. Review. https://www.annfammed.org/content/22/1/50