Assessments in Alzheimer's patients treated with plasma exchange

 Mercè Boada,Oscar L. López,Javier Olazarán,Laura Núñez,Michael Pfeffer,Orlando Puente,Gerard Piñol-Ripoll,José E. Gámez,Fernando Anaya,Dobri Kiprov,Montserrat Alegret …

DOI:  https://doi.org/10.1002/alz.12477

PDF: https://alz-journals.onlinelibrary.wiley.com/doi/epdf/10.1002/alz.12477

Abstract

Introduction

We report the effects of plasma exchange (PE) with albumin replacement on neuropsychological, neuropsychiatric, and quality-of-life (QoL) outcomes in mild-to-moderate Alzheimer's disease (AD) patients in a phase 2b/3 trial (Alzheimer's Management by Albumin Replacement [AMBAR] study).

Methods

Three hundred forty-seven patients were randomized into placebo (sham-PE) and three PE-treatment arms with low/high doses of albumin, with/without intravenous immunoglobulin (IVIG). Specific test measurements were performed at baseline; month 2 (weekly conventional PE); months 6, 9, and 12 (monthly low-volume PE [LVPE]); and month 14.

Results

The PE-treated mild-AD cohort improved their language fluency and processing speed versus placebo at month 14 (effect sizes: >100%; P-values: .03 to .001). The moderate-AD cohort significantly improved short-term verbal memory (effect sizes: 94% to >100%; P-values: .02 to .003). The progression of the neuropsychiatric symptoms of PE-treated was similar to placebo. Mild-AD patients showed improved QoL (P-values: .04 to .008).

Discussion

PE-treated AD patients showed improvement in memory, language abilities, processing speed, and QoL-AD. No worsening of their psychoaffective status was observed.

https://alz-journals.onlinelibrary.wiley.com/doi/full/10.1002/alz.12477