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Active Aβ immunotherapy CAD106 in Alzheimer's disease: A phase 2b study

vandenberghe, Rik and Riviere, Marie-Emmanuelle and Caputo, Angelika and Maguire, Paul and farlow, martin and marotta, giovanni and sanchez-valle, raquel and scheltens, philip and Graf, Ana and Ryan, Joseph and Sovago, Judit (2017) Active Aβ immunotherapy CAD106 in Alzheimer's disease: A phase 2b study. Alzheimer's and Dementia: Translational Research and Clinical Interventions, 3 (1). pp. 10-22. ISSN 2352-8737

Abstract

Introduction This randomized, double-blind, placebo-controlled, 90-week study assessed safety, tolerability, and immunogenicity of CAD106 with/without adjuvant in patients with mild Alzheimer's disease. Methods One hundred twenty-one patients received up to seven intramuscular injections of CAD106 (150 μg or 450 μg) or placebo ± adjuvant over 60 weeks. An amyloid positron emission tomography (PET) substudy was also conducted. Results CAD106 induced strong serological responses (amyloid-beta [Aβ]–Immunoglobuline G[IgG]) in 55.1% (150 μg) and 81.1% (450 μg) of patients (strong serological responders [SSRs]). Serious adverse events (SAEs) were reported in 24.5% (95% confidence interval [CI] 16.7–33.8) of the patients in the active treatment group and in 6.7% (95% CI 0.2–31.9) in the placebo group. Three of the SAEs were classified as possibly related to study drug by the investigators. No evidence of central nervous system inflammation was found. Amyloid-related imaging abnormalities (ARIAs) occurred in six cases, all of them were strong serological responders. None of the ARIAs were symptomatic. Serum Aβ-IgG titer area under the curves correlated negatively with amyloid PET standardized uptake value ratio percentage change from baseline to week 78 within the CAD106-treated patients (r = −0.84, P = .0004). Decrease in cortical gray-matter volume from baseline to week 78 was larger in SSRs than in controls (P = .0077). Discussion Repeated CAD106 administration was generally well tolerated. CAD106 450 μg with alum adjuvant demonstrated the best balance between antibody response and tolerability.

Item Type: Article
Keywords: Active immunotherapy Alzheimer's disease Amyloid-beta peptides Biological biomarkers CAD106 Safety
Date Deposited: 25 Oct 2017 00:45
Last Modified: 25 Jan 2019 00:45
URI: https://oak.novartis.com/id/eprint/23547

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