Immunotherapies banish amyloid from the brain

At least four anti-amyloid immunotherapies have now demonstrated the ability to clear plaques from the brain: aducanumab, gantenerumab, Lilly’s LY3002813, and BAN2401. At the Alzheimer’s Association International Conference, held July 22–26 in Chicago, scientists presented new data from gantenerumab and LY3002813, aka N3pG. They showed that these antibodies can mop up brain amyloid, bringing many people with early symptomatic Alzheimer’s disease below the threshold for amyloid positivity. Gregory Klein at Roche claimed that two years of treatment with high-dose gantenerumab essentially resets a person’s trajectory of amyloid accumulation.

 

  • After two years, half of AD patients taking gantenerumab become amyloid-negative.
  • One-third develop ARIA-E, usually without symptoms.
  • Lilly’s N3pG, directed against pyroglutamate Aβ, clears plaques in six months.

 

Encouraging
Other researchers found the data encouraging. “It’s impressive there are now four drugs that can remove amyloid plaques from the brain,” Randall Bateman of Washington University, St. Louis, wrote to Alzforum. However, clinicians noted that the jury is still out on how much this will help AD patients. “Several of the antibodies are looking good at removing amyloid, but the clinical efficacy still needs to be demonstrated,” said Ron Petersen of the Mayo Clinic in Rochester, Minnesota.

 

Significant reduction in amyloid plaque burden
Previously, at the 2017 CTAD conference, Roche scientists presented six-to-nine-month gantenerumab data from ongoing open-label extensions of two Phase 3 studies. Participants were titrated up from 105 or 225 mg subcutaneous gantenerumab to 1,200 mg, and after nine months, their amyloid had receded by 15 percent, with one-third of participants dipping below the threshold of brain-wide amyloid positivity.

Video: Higher dose Gantenerumab leads to significant reduction in amyloid plaque burden –
Results for the Marguerite and Scarlet Road Open Label Extension Studies Gregory Klein, PhD at Roche, Basel (CH) – CTAD Conference 2017.

 

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Source: Alzforum | 17 August 2018

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