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Efficacy assessment...
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Cullen, Nicholas C.Lund University,Lunds universitet,Klinisk minnesforskning,Forskargrupper vid Lunds universitet,Clinical Memory Research,Lund University Research Groups
(author)
Efficacy assessment of an active tau immunotherapy in Alzheimer's disease patients with amyloid and tau pathology : a post hoc analysis of the “ADAMANT” randomised, placebo-controlled, double-blind, multi-centre, phase 2 clinical trial
- Article/chapterEnglish2024
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LIBRIS-ID:oai:lup.lub.lu.se:5257028c-e168-443e-a6ea-21fde282e043
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https://lup.lub.lu.se/record/5257028c-e168-443e-a6ea-21fde282e043URI
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https://doi.org/10.1016/j.ebiom.2023.104923DOI
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http://kipublications.ki.se/Default.aspx?queryparsed=id:154606349URI
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Language:English
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Summary in:English
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Subject category:art swepub-publicationtype
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Subject category:ref swepub-contenttype
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Background: Tau pathology correlates with and predicts clinical decline in Alzheimer's disease. Approved tau-targeted therapies are not available. Methods: ADAMANT, a 24-month randomised, placebo-controlled, parallel-group, double-blinded, multicenter, Phase 2 clinical trial (EudraCT2015-000630-30, NCT02579252) enrolled 196 participants with Alzheimer's disease; 119 are included in this post-hoc subgroup analysis. AADvac1, active immunotherapy against pathological tau protein. A machine learning model predicted likely Amyloid+Tau+ participants from baseline MRI. Statistical methods: MMRM for change from baseline in cognition, function, and neurodegeneration; linear regression for associations between antibody response and endpoints. Results: The prediction model achieved PPV of 97.7% for amyloid, 96.2% for tau. 119 participants in the full analysis set (70 treatment and 49 placebo) were classified as A+T+. A trend for CDR-SB 104-week change (estimated marginal means [emm] = −0.99 points, 95% CI [−2.13, 0.13], p = 0.0825]) and ADCS-MCI-ADL (emm = 3.82 points, CI [−0.29, 7.92], p = 0.0679) in favour of the treatment group was seen. Reduction was seen in plasma NF-L (emm = −0.15 log pg/mL, CI [−0.27, −0.03], p = 0.0139). Higher antibody response to AADvac1 was related to slowing of decline on CDR-SB (rho = −0.10, CI [−0.21, 0.01], p = 0.0376) and ADL (rho = 0.15, CI [0.03, 0.27], p = 0.0201), and related to slower brain atrophy (rho = 0.18–0.35, p < 0.05 for temporal volume, whole cortex, and right and left hippocampus). Conclusions: In the subgroup of ML imputed or CSF identified A+T+, AADvac1 slowed AD-related decline in an antibody-dependent manner. Larger anti-tau trials are warranted. Funding: AXON Neuroscience SE.
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Novak, PetrAxon Neuroscience SE
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Tosun, DuyguSan Francisco Veterans Administration Medical Center,University of California, San Francisco
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Kovacech, BranislavAxon Neuroscience SE
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Hanes, Jozef
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Kontsekova, Eva
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Fresser, MichalAxon Neuroscience SE
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Ropele, StefanMedical University of Graz
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Feldman, Howard H.
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Schmidt, ReinholdMedical University of Graz
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Winblad, BengtKarolinska Institutet,Karolinska University Hospital
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Zilka, NorbertAxon Neuroscience SE
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Klinisk minnesforskningForskargrupper vid Lunds universitet
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In:EBioMedicine992352-3964
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Cullen, Nicholas ...
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Novak, Petr
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Tosun, Duygu
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Kovacech, Branis ...
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Hanes, Jozef
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Kontsekova, Eva
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Fresser, Michal
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Ropele, Stefan
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Feldman, Howard ...
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Schmidt, Reinhol ...
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Winblad, Bengt
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Zilka, Norbert
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Karolinska Institutet