Perspectives on the clinical use of anti-amyloid therapy for the treatment of Alzheimer's disease: Insights from the fields of cancer, rheumatology, and neurology

Gregory A. Jicha, Erin L. Abner, Elif P. Coskun, Mark J. Huffmyer, Thomas C. Tucker, Peter T. Nelson
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Abstract

Introduction

The advent of disease-modifying therapies for Alzheimer's disease (AD) has raised many questions and debates in the field as to the clinical benefits, risks, and costs of such therapies. The controversies have resulted in the perception that many clinicians are apprehensive about prescribing these medications to their patient populations. There also remains widespread uncertainty as to the economic impact, cost benefit ratio, and safety oversight for use of these medications in standard clinical care settings.

Methods

To contextualize such issues, the present study compared anti-amyloid biologic therapy (lecanemab) to four commonly used biologic agents in other fields, including trastuzumab for breast cancer, bevacizumab for lung cancer, etanercept for rheumatoid arthritis, and ocrelizumab for multiple sclerosis.

Results

The data presented demonstrate comparable costs, clinical benefits, and risks for these biologic agents in their disparate disease states.

Discussion

These results provide context for the costs, clinical benefits, and safety regarding the mainstream use of anti-amyloid biologic agents for the prevention of cognitive loss. While the era of disease-modifying therapies for AD is now in its infancy, there is an expectation that these discoveries will be followed by improved therapies and combination treatments leading to greater efficacy in ameliorating the clinical trajectory of AD.

Highlights

  • Anti-amyloid therapy costs are comparable to other commonly used biologics.
  • Anti-amyloid therapy efficacy is comparable to other commonly used biologics.
  • Anti-amyloid therapy safety is compatible with other commonly used biologics.
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抗淀粉样蛋白疗法治疗阿尔茨海默病的临床应用前景:来自癌症、风湿病学和神经病学领域的见解
导言:针对阿尔茨海默病(AD)的疾病修饰疗法的出现在该领域引发了许多关于此类疗法的临床益处、风险和成本的问题和争论。这些争论导致许多临床医生对向患者开具此类药物处方心存疑虑。此外,在标准临床护理环境中使用这些药物的经济影响、成本效益比和安全监管方面也仍然存在广泛的不确定性。 方法 为了说明这些问题,本研究将抗淀粉样蛋白生物疗法(lecanemab)与其他领域常用的四种生物制剂进行了比较,包括治疗乳腺癌的曲妥珠单抗、治疗肺癌的贝伐珠单抗、治疗类风湿性关节炎的依那西普(etanercept)以及治疗多发性硬化症的奥克立珠单抗。 结果 所提供的数据表明,这些生物制剂在不同疾病状态下的成本、临床疗效和风险具有可比性。 讨论 这些结果为主流使用抗淀粉样蛋白生物制剂预防认知功能丧失的成本、临床获益和安全性提供了依据。虽然针对 AD 的疾病改变疗法目前尚处于起步阶段,但人们期待着这些发现会带来更先进的疗法和联合疗法,从而在改善 AD 临床症状方面取得更大的疗效。 亮点 抗淀粉样蛋白疗法的成本与其他常用生物制剂相当。 抗淀粉样蛋白疗法的疗效与其他常用生物制剂相当。 抗淀粉样蛋白疗法的安全性与其他常用生物制剂相当。
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来源期刊
CiteScore
10.10
自引率
2.10%
发文量
134
审稿时长
10 weeks
期刊介绍: Alzheimer''s & Dementia: Translational Research & Clinical Interventions (TRCI) is a peer-reviewed, open access,journal from the Alzheimer''s Association®. The journal seeks to bridge the full scope of explorations between basic research on drug discovery and clinical studies, validating putative therapies for aging-related chronic brain conditions that affect cognition, motor functions, and other behavioral or clinical symptoms associated with all forms dementia and Alzheimer''s disease. The journal will publish findings from diverse domains of research and disciplines to accelerate the conversion of abstract facts into practical knowledge: specifically, to translate what is learned at the bench into bedside applications. The journal seeks to publish articles that go beyond a singular emphasis on either basic drug discovery research or clinical research. Rather, an important theme of articles will be the linkages between and among the various discrete steps in the complex continuum of therapy development. For rapid communication among a multidisciplinary research audience involving the range of therapeutic interventions, TRCI will consider only original contributions that include feature length research articles, systematic reviews, meta-analyses, brief reports, narrative reviews, commentaries, letters, perspectives, and research news that would advance wide range of interventions to ameliorate symptoms or alter the progression of chronic neurocognitive disorders such as dementia and Alzheimer''s disease. The journal will publish on topics related to medicine, geriatrics, neuroscience, neurophysiology, neurology, psychiatry, clinical psychology, bioinformatics, pharmaco-genetics, regulatory issues, health economics, pharmacoeconomics, and public health policy as these apply to preclinical and clinical research on therapeutics.
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