Demonstration of safety of intravenous immunoglobulin in geriatric patients in a long‐term, placebo‐controlled study of Alzheimer's disease

David Gelmont1, Ronald G. Thomas2, Jonathan Britt1, Jacqueline A. Dyck-Jones1, Jennifer Doralt3, Sandor Fritsch3, James B. Brewer2, Robert A. Rissman2, Paul Aisen4
1Clinical Development, Baxalta US Inc., Westlake Village, CA, USA
2ADCS Alzheimer's Disease Cooperative Study, UCSD, La Jolla, CA, USA
3Clinical Development, Baxalta Innovations GmbH, Vienna, Austria
4USC Alzheimer's Therapeutic Research Institute, San Diego, CA, USA

Tóm tắt

AbstractIntroductionWe present safety results from a study of Gammagard Liquid intravenous immunoglobulin (IGIV) in patients with probable Alzheimer's disease.MethodsThis was a placebo‐controlled double‐blind study. Subjects were randomized to 400 mg/kg (n = 127), 200 mg/kg (n = 135) IGIV, or to 0.25% human albumin (n = 121) administered every 2 weeks ± 7 days for 18 months.ResultsElevated risk ratios of IGIV versus placebo included chills (3.85) in 9.5% of IGIV‐treated subjects (all doses), compared to 2.5% of placebo‐treated subjects, and rash (3.08) in 15.3% of IGIV‐treated subjects versus 5.0% of subjects treated with placebo. Subjects in the highest IGIV dose group had the lowest proportion of SAEs considered related to product (2 of 127 [1.6%]). Subjects treated with IGIV experienced a lower rate of respiratory and all other infections compared to placebo.DiscussionIGIV‐treated subjects did not experience higher rates of renal failure, lung injury, or thrombotic events than the placebo group. There were no unexpected safety findings. IGIV was well tolerated throughout 18 months of treatment in subjects aged 50–89 years.

Tài liệu tham khảo

United Kingdom D o H, 2011, Clinical guidelines for immunoglobulin use, 48 10.1002/ana.10253 10.1093/brain/awg191 Du Y., 2005, Treatment with purified human anti‐Abeta antibodies alters beta‐amyloid levels in the serum, CSF, and Brain of APPV717F transgenic mice, Neurology, 64, A415 10.1016/j.jalz.2007.04.021 10.1002/jnr.20886 10.4049/jimmunol.176.11.7071 10.1136/jnnp.2003.033399 10.1016/j.neurobiolaging.2007.12.021 Tsakanikas D., 2008, Effects of uninterrupted intravenous immunoglobulin treatment of Alzeheimer's disease for nine months, Neurology, T776 Relkin N., 2010, Intravenous immunoglobulin treatment deceases rates of ventricular enlargement and cognitive decline in Alzheimer's Disease, Neurology, 70 Puli L., 2014, Intravenous immunoglobulins for Alzheimer's disease, Curr Alzheimer Res, 11, 626, 10.2174/1567205011666140812113415 10.1111/cei.12500 10.2146/ajhp070582 10.2165/11592740-000000000-00000 Romm J., 2013, Efficacy and safety of intravenous immunoglobulin in elderly patients with primary immune deficiency, Ann Allergy Asthma Immunol, 111, A83 10.1007/s40266-013-0079-7 10.1007/s00277-012-1567-2 10.1111/j.1532-5415.2007.01516.x Kile S., 2015, IVIG treatment of mild cognitive impairment due to Alzheimer's disease: A randomised double‐blinded exploratory study of the effect on brain atrophy, cognition and conversion to dementia, J Neurol Neurosurg Psychiatry, 8 10.1111/jns5.12046 10.1001/archneurol.2010.223 10.2307/2530610 2011, Anti‐A, anti‐B haemagglutinins. European Pharmacopoeia Baxter Healthcare Corporation, 2014 10.1186/1742-2094-10-70 10.2174/157488607779315480 10.1111/j.1537-2995.2012.03589.x 10.1111/j.1537-2995.2012.03868.x 10.1517/14712598.2013.789856 10.1016/j.jalz.2011.05.2351 10.1016/S1474-4422(13)70014-0 Welles C.C., 2009, Hemoglobinuria and Acute Kidney Injury Requiring Hemodialysis Following Intravenous Immunoglobulin Infusion, Am J Kidney Dis, 55, 148, 10.1053/j.ajkd.2009.06.013 Thomas M.J., 1993, Hemolysis after high‐dose intravenous Ig, Blood J Am Soc Hematol, 82, 3789 Markvardsen L.H., 2012, Haemolytic anaemia as a complication to intravenous immunoglobulin infusion, Eur J Neurol, 19, 779 10.1111/ene.12287 10.1111/trf.13105 10.1007/s10875-006-9025-3 10.1086/520200 10.1002/eji.201444878 10.1189/jlb.5MR0315-104R