Carregant...
Fitxers
Tipus de document
ArticleVersió
Versió acceptadaData de publicació
Tots els drets reservats
Si us plau utilitzeu sempre aquest identificador per citar o enllaçar aquest document: https://hdl.handle.net/2445/140678
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
Títol de la revista
Director/Tutor
ISSN de la revista
Títol del volum
Recurs relacionat
Resum
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.
Matèries (anglès)
Citació
Citació
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. 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. _Journal of Alzheimer's Disease_. 2017. Vol. 56, núm. 1, pàgs. 129-143. [consulta: 23 de gener de 2026]. ISSN: 1387-2877. [Disponible a: https://hdl.handle.net/2445/140678]