Slow down Alzheimer's
Clinical studies have shown a reduction in the progression of Alzheimer's disease by more than half
A Phase III Trial Based on the Peripheral Amyloid Sink Concept Succeeds in Slowing Alzheimer's Disease, FightAging!
Translated by Ariel Finerman, Habr
In a phase III clinical trial, the progression of the disease decreased by more than half in patients with mild to moderate Alzheimer's disease. The therapy involved removing beta-amyloid from the blood, not from the brain. The levels of β-amyloid are dynamic, and there is an equilibrium between its amount in the brain and in the blood. Past trials have shown that reducing the level of β-amyloid in the blood can reduce its presence in the brain, which is the result of a new equilibrium.
The trial seems to be an important confirmation of the amyloid hypothesis of Alzheimer's disease, just at a time of its intense criticism. The history of unsuccessful attempts to reduce the level of β-amyloid has led to a variety of competing initiatives and increased attention to tau aggregation as the main cause of pathology in the later stages of the disease. I also see in the test some signs in favor of the concept of impaired filtration of cerebrospinal fluid (CSF) in the brain. In it, the pathways by which CSF exits the brain atrophy with age, and the rate of metabolic garbage collection decreases.
Alzheimer Management by Albumin Replacement (AMBAR) is an international, multicenter, randomized, blind, placebo–controlled, parallel group clinical trial involving patients with mild to moderate Alzheimer's disease from 41 centers in Europe and the USA. The aim of the trial was to evaluate the efficacy and safety of short-term plasma replacement, and then long-term plasmapheresis with injections of human albumin in combination with intravenous infusion of immunoglobulin in patients with mild to moderate Alzheimer's disease.
AMBAR is based on the hypothesis that most of the β-amyloid accumulated in the brains of patients with Alzheimer's disease is associated with albumin and circulates in plasma. The extraction of these aggregates from the blood can lead to the migration of beta-amyloid from the brain into plasma, which reduces the effect of the disease on the cognitive functions of the patient. In addition, albumin may represent an integrated approach to the treatment of the disease due to its binding ability, antioxidant, immunomodulatory and anti-inflammatory properties.
The AMBAR trial included 496 patients with mild to moderate Alzheimer's disease randomized in three treatment groups and one placebo group. The participants were 55-85 years old, and the effectiveness of treatment was measured by changes in cognition and in indicators of daily life. An independent research organization (CRO) supervised the clinical trial and the stages of information collection and analysis. The trial used randomized and double-blind control, which meant that patients, doctors and examiners did not know whether the patients were using treatment or placebo.
AMBAR tests have shown positive, very relevant results in patients suffering from moderate Alzheimer's disease.
Drawings from the report of the AMBAR Project Manager at the Clinical Trials on Alzheimer's Disease Congress (Barcelona, October 27, 2018) – WM.
Doctors found a 50-75% decrease in progression in the cognitive Alzheimer's Disease assessment scale (ADAS-Cog) and 42-70% in the daily life assessment scale (ADCS-ADL) in patients receiving treatment. Including all patients receiving plasma replacement, the difference was 66% for the ADAS-Cog scale and 52% for the ADCS-ADL scale.
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