title: Safety and Efficacy of Anti-Amyloid-β Immunotherapy in Alzheimer's Disease: A Systematic Review and Meta-Analysis.
abstract: Immunotherapeutics targeting amyloid-β (Aβ) have had mixed results in clinical trials. The present study aims to evaluate the safety and clinical efficacy of immunotherapeutic agents targeting Aβ in Alzheimer's disease. Randomised controlled trials of at least two weeks duration were included in the review. Fourteen randomised controlled trials (n = 5554) were identified in a systematic search of eight electronic databases. Upon pooling of data, there was no increased risk of any adverse event, serious adverse events, or death with the exception of a near fivefold increase in amyloid-related imaging abnormalities (ARIA; OR 4.79, 95% CI 1.24-18.55; p = 0.02). Of the cognitive indicators, the Mini-Mental State Examination (MMSE) showed a small statistically significant improvement (diff in means =0.44; p = 0.02), while the others (ADAS-cog, ADCS-ADL, and CDR-sb) showed no change. Therefore, immunotherapeutic agents have been relatively well tolerated, with some promise for cognitive improvements if the occurrence of ARIA can be mitigated.
authors.affiliation: The Whiteley-Martin Research Centre, Discipline of Surgery, The University of Sydney, P.O. Box 63, Nepean Hospital, Penrith, NSW, Australia.
authors.forename: Ross
authors.initials: R
authors.lastname: Penninkilampi
authors.affiliation: Department of Psychology, The Ohio State University, Columbus, OH, USA.
authors.forename: Holly M
authors.initials: HM
authors.lastname: Brothers
authors.affiliation: The Whiteley-Martin Research Centre, Discipline of Surgery, The University of Sydney, P.O. Box 63, Nepean Hospital, Penrith, NSW, Australia. guy.eslick@sydney.edu.au.
authors.forename: Guy D
authors.initials: GD
authors.lastname: Eslick
mesh_terms: D000544:Alzheimer Disease / Q000188:drug therapy* / Q000276:immunology; D016229:Amyloid beta-Peptides / Q000037:antagonists & inhibitors* / Q000276:immunology; D002800:Cholinesterase Inhibitors / Q000494:pharmacology / Q000627:therapeutic use; D006801:Humans; D007167:Immunotherapy / Q000379:methods* / Q000639:trends; D016032:Randomized Controlled Trials as Topic / Q000379:methods; D016896:Treatment Outcome
chemical_list: D016229:Amyloid beta-Peptides; D002800:Cholinesterase Inhibitors
keywords: Alzheimer’s disease; Amyloid-β; Immunotherapy; Meta-analysis, ARIA