Bapineuzumab.
BACKGROUND
Alzheimer's disease is the leading cause of dementia in the elderly, and there is no disease-modifying therapy yet available. Immunotherapy directed against the beta-amyloid peptide may be capable of slowing the rate of disease progression. Bapineuzumab, an anti-beta-amyloid monoclonal antibody, will be the first such agent to emerge from Phase III clinical trials.


METHODS
The primary literature on bapineuzumab from 2009 and 2010 is reviewed in its entirety, along with the literature on AN1792, a first-generation anti-beta-amyloid vaccine, from 2003 to 2009. Other Alzheimer's disease immunotherapeutics currently in development, according to www.clinicaltrials.gov , are also discussed.


RESULTS
In addition to a critical appraisal of the Phase II trial results for bapineuzumab, this review considers the broader field of immunotherapy for Alzheimer's disease as a whole, including the challenges ahead.


CONCLUSIONS
Bapineuzumab appears capable of reducing the cerebral beta-amyloid peptide burden in patients with Alzheimer's disease. However, particularly in APOE 4 carriers, its ability to slow disease progression remains uncertain, and vasogenic edema - a dose-limiting and potentially severe adverse reaction - may limit its clinical applicability.
Kerchner
Geoffrey A
GA
Stanford University School of Medicine, Stanford Center for Memory Disorders, 300 Pasteur Drive, Room A343, Stanford, CA 94305-5235, USA.
Boxer
Adam L
AL
D000544:Alzheimer Disease / Q000188:drug therapy* / Q000235:genetics / Q000276:immunology; D023582:Alzheimer Vaccines / Q000627:therapeutic use; D016229:Amyloid beta-Peptides / Q000276:immunology* / Q000627:therapeutic use; D000911:Antibodies, Monoclonal / Q000009:adverse effects / Q000627:therapeutic use*; D061067:Antibodies, Monoclonal, Humanized; D053327:Apolipoprotein E4 / Q000235:genetics; D001929:Brain Edema / Q000139:chemically induced / Q000235:genetics; D017322:Clinical Trials, Phase II as Topic; D017326:Clinical Trials, Phase III as Topic; D019317:Evidence-Based Medicine; D006801:Humans; D007167:Immunotherapy / Q000379:methods*; D018697:Nootropic Agents / Q000009:adverse effects / Q000627:therapeutic use*; D016896:Treatment Outcome
C437846:AN-1792; D023582:Alzheimer Vaccines; D016229:Amyloid beta-Peptides; D000911:Antibodies, Monoclonal; D061067:Antibodies, Monoclonal, Humanized; D053327:Apolipoprotein E4; D018697:Nootropic Agents; C545458:bapineuzumab