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Title: Efficacy and safety of plasma exchange with 5% albumin to modify cerebrospinal fluid and plasma amyloid-β concentrations and cognition outcomes in Alzheimer's disease patients: a multicenter, randomized, controlled clinical trial
Author: Boada, Mercè
Anaya, Fernando
Ortiz, Pilar
Olazarán, Javier
Shua-Haim, Joshua R.
Obisesan, Thomas O.
Hernández, Isabel
Muñoz, Joan
Buendia, Mar
Alegret i Llorens, Montse
Lafuente, Asunción
Tárraga, Lluís
Núñez Doménech, Laura
Torres Hurtado, Mirea
Grífols, Joan Ramon
Ferrer, Isidro (Ferrer Abizanda)
Lopez, Oscar L.
Páez, Antonio
Keywords: Albúmines
Ús terapèutic
Líquid cefalorraquidi
Trastorns de la cognició
Therapeutic use
Cerebrospinal fluid
Cognition disorders
Issue Date: Jan-2017
Publisher: IOS Press
Abstract: Background: studies conducted in animal models and humans suggest the presence of a dynamic equilibrium of amyloid-β (Aβ) peptide between cerebrospinal fluid (CSF) and plasma compartments. Objective: to determine whether plasma exchange (PE) with albumin replacement was able to modify Aβ concentrations in CSF and plasma as well as to improve cognition in patients with mild-moderate Alzheimer's disease (AD). Methods: in a multicenter, randomized, patient- and rater-blind, controlled, parallel-group, phase II study, 42 AD patients were assigned (1 : 1) to PE treatment or control (sham) groups. Treated patients received a maximum of 18 PE with 5% albumin (Albutein®, Grifols) with three different schedules: two PE/weekly (three weeks), one PE/weekly (six weeks), and one PE/bi- weekly (12 weeks), plus a six-month follow-up period. Plasma and CSF Aβ1-40 and Aβ1-42 levels, as well as cognitive, functional, and behavioral measures were determined. Results: CSF Aβ1-42 levels after the last PE compared to baseline were marginally higher in PE-treated group versus controls (adjusted means of variation: 75.3 versus -45.5 pg/mL; 95% CI: -19.8, 170.5 versus 135.1, 44.2; p = 0.072). Plasma Aβ1-42 levels were lower in the PE-treated group after each treatment period (p < 0.05). Plasma Aβ1-40 levels showed a saw-tooth pattern variation associated with PE. PE-treated patients scored better in the Boston Naming Test and Semantic Verbal Fluency (p < 0.05) throughout the study. Neuropsychiatric Inventory scores were higher in controls during the PE phase (p < 0.05). Conclusion: PE with human albumin modified CSF and plasma Aβ1-42 levels. Patients treated with PE showed improvement in memory and language functions, which persisted after PE was discontinued.
Note: Versió postprint del document publicat a:
It is part of: Journal of Alzheimer's Disease, 2017, vol. 56, num. 1, p. 129-143
Related resource:
ISSN: 1387-2877
Appears in Collections:Articles publicats en revistes (Patologia i Terapèutica Experimental)

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