Title | 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. |
Publication Type | Journal Article |
Year of Publication | 2017 |
Authors | Boada, M, Anaya, F, Ortiz, P, Olazarán, J, Shua-Haim, JR, Obisesan, TO, Hernandez, I, Muñoz, J, Buendia, M, Alegret, M, Lafuente, A, Tárraga, L, Núñez, L, Torres, M, Grifols, JRamon, Ferrer, I, Lopez, OL, Páez, A |
Journal | J Alzheimers Dis |
Volume | 56 |
Issue | 1 |
Pagination | 129-143 |
Date Published | 2017 |
ISSN | 1875-8908 |
Abstract | 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 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. |
DOI | 10.3233/JAD-160565 |
Alternate Journal | J. Alzheimers Dis. |
PubMed ID | 27911295 |
PubMed Central ID | PMC5240541 |
Grant List | UL1 TR001409 / TR / NCATS NIH HHS / United States |