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The phase 3 trial of IV immunoglobulin for Alzheimer disease did not show beneficial effects on cognition or function relative to participants who received placebo. Research Associate Fabrizio Piazza comments that failure of the IV immunoglobulin trial highlights the need to identify optimal drug dosing and timing in order to maximize efficacy while reducing the occurrence of amyloid-related imaging abnormalities (ARIA) side effects. He refers to a study with aducanumab that showed that a reduction in brain-deposited Aβ and cognitive decline were accompanied by high occurrences of ARIA. He stresses that understanding the mechanisms and significance of ARIA is necessary for the design of more effective clinical trials in immunotherapy and Alzheimer disease. In response, Aisen et al. explain that while ARIA may complicate effective antifibrillar immunotherapy, it may not be an important issue for immunotherapy programs targeting midsequence or other epitopes not dependent on plaque reduction for potential therapeutic effect.
The phase 3 trial of IV immunoglobulin for Alzheimer disease did not show beneficial effects on cognition or function relative to participants who received placebo. Research Associate Fabrizio Piazza comments that failure of the IV immunoglobulin trial highlights the need to identify optimal drug dosing and timing in order to maximize efficacy while reducing the occurrence of amyloid-related imaging abnormalities (ARIA) side effects.
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