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Two Randomized Phase 3 Studies of Aducanumab in Early Alzheimer's Disease

The Journal of Prevention of Alzheimer's Disease, ISSN: 2274-5807, Vol: 9, Issue: 2, Page: 197-210
2022
  • 673
    Citations
  • 0
    Usage
  • 705
    Captures
  • 44
    Mentions
  • 0
    Social Media
Metric Options:   Counts1 Year3 Year

Metrics Details

  • Citations
    673
    • Citation Indexes
      665
    • Policy Citations
      7
      • 7
    • Patent Family Citations
      1
      • 1
  • Captures
    705
  • Mentions
    44
    • News Mentions
      43
      • 43
    • Blog Mentions
      1
      • Blog
        1

Most Recent News

2021: Anti-amyloid antibodies take a bumpy road to the clinic

Nature, Published online: 26 September 2024; doi:10.1038/d41586-024-02952-y The arrival of the first disease-modifying therapy for Alzheimer’s was significant, but it was not met with the joy that might have been expected.

Article Description

Alzheimer's disease is a progressive, irreversible, and fatal disease for which accumulation of amyloid beta is thought to play a key role in pathogenesis. Aducanumab is a human monoclonal antibody directed against aggregated soluble and insoluble forms of amyloid beta. We evaluated the efficacy and safety of aducanumab in early Alzheimer's disease. EMERGE and ENGAGE were two randomized, double-blind, placebo-controlled, global, phase 3 studies of aducanumab in patients with early Alzheimer's disease. These studies involved 348 sites in 20 countries. Participants included 1638 (EMERGE) and 1647 (ENGAGE) patients (aged 50–85 years, confirmed amyloid pathology) who met clinical criteria for mild cognitive impairment due to Alzheimer's disease or mild Alzheimer's disease dementia, of which 1812 (55.2%) completed the study. Participants were randomly assigned 1:1:1 to receive aducanumab low dose (3 or 6 mg/kg target dose), high dose (10 mg/kg target dose), or placebo via IV infusion once every 4 weeks over 76 weeks. The primary outcome measure was change from baseline to week 78 on the Clinical Dementia Rating Sum of Boxes (CDR-SB), an integrated scale that assesses both function and cognition. Other measures included safety assessments; secondary and tertiary clinical outcomes that assessed cognition, function, and behavior; and biomarker endpoints. EMERGE and ENGAGE were halted based on futility analysis of data pooled from the first approximately 50% of enrolled patients; subsequent efficacy analyses included data from a larger data set collected up to futility declaration and followed prespecified statistical analyses. The primary endpoint was met in EMERGE (difference of -0.39 for high-dose aducanumab vs placebo [95% CI, -0.69 to -0.09; P=.012; 22% decrease]) but not in ENGAGE (difference of 0.03, [95% CI, -0.26 to 0.33; P=.833; 2% increase]). Results of biomarker substudies confirmed target engagement and dose-dependent reduction in markers of Alzheimer's disease pathophysiology. The most common adverse event was amyloid-related imaging abnormalities-edema. Data from EMERGE demonstrated a statistically significant change across all four primary and secondary clinical endpoints. ENGAGE did not meet its primary or secondary endpoints. A dose-and time-dependent reduction in pathophysiological markers of Alzheimer's disease was observed in both trials.

Bibliographic Details

Samantha Budd Haeberlein; S. Chalkias; T. Chen; G. Dent; K. Harrison; C. von Hehn; C. Mallinckrodt; K. K. Muralidharan; I. Nestorov; L. Nisenbaum; R. Rajagovindan; L. Skordos; Y. Tian; S. Wu; Y. Zhu; A. Sandrock; P. S. Aisen; F. Barkhof; S. Cohen; O. Hansson; T. Iwatsubo; C. J. Mummery; C. H. van Dyck; B. Vellas

Elsevier BV

Medicine

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