Amyloid-targeted therapeutics in Alzheimer's disease: use of human albumin in plasma exchange as a novel approach for Abeta mobilization

Drug News Perspect. Jul-Aug 2009;22(6):325-39. doi: 10.1358/dnp.2009.22.6.1395256.

Abstract

A clinical investigation program was carried out to replace endogenous albumin of patients with mild to moderate Alzheimer's disease (AD) with 5% Human Albumin Grifols(R) through a plasma exchange (PE) schedule, in order to alter the dynamic equilibrium between albumin-bound Abeta in plasma and Abeta in cerebrospinal fluid. In a pilot proof-of-concept study, 7 patients underwent 6 PE in 3 weeks and 1 year of follow-up. Plasma Abeta determinations demonstrated a variation pattern in levels in relation with the PEs. Cognitive status scores (MMSE and ADAS-Cog) were more stable than expected. In a phase II clinical trial, 29 patients were randomized into PEtreated and control groups with 1 year follow-up. Interim results point toward the occurrence of Abeta40 mobilization in the PE-treated patients, who scored better in cognitive tests (differences at 9 months: 2.5 in MMSE and 5.5 in ADAS-cog). These results suggest that a PE program with 5% Human Albumin Grifols may have a promising role in the treatment of mild to moderate AD.

Publication types

  • Research Support, Non-U.S. Gov't
  • Review

MeSH terms

  • Alzheimer Disease / physiopathology
  • Alzheimer Disease / therapy*
  • Amyloid beta-Peptides / metabolism
  • Animals
  • Clinical Trials as Topic
  • Cognition Disorders / etiology
  • Cognition Disorders / therapy
  • Drug Delivery Systems
  • Humans
  • Plasma Exchange / methods*
  • Serum Albumin / administration & dosage*
  • Serum Albumin / metabolism

Substances

  • Amyloid beta-Peptides
  • Serum Albumin