Efficacy and Safety of Plasma Exchange with 5% Albumin to Modify Cerebrospinal Fluid and Plasma Amyloid-? Concentrations and Cognition Outcomes in Alzheimer's Disease Patients: A Multicenter, Randomized, Controlled Clinical Trial.

ABSTRACT: Studies conducted in animal models and humans suggest the presence of a dynamic equilibrium of amyloid-? (A?) peptide between cerebrospinal fluid (CSF) and plasma compartments.To determine whether plasma exchange (PE) with albumin replacement was able to modify A? concentrations in CSF and plasma as well as to improve cognition in patients with mild-moderate Alzheimer's disease (AD).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 A?1-40 and A?1-42 levels, as well as cognitive, functional, and behavioral measures were determined.CSF A?1-42 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 A?1-42 levels were lower in the PE-treated group after each treatment period (p?

SUBMITTER: Boada M 

PROVIDER: S-EPMC5240541 | biostudies-literature | 2017

REPOSITORIES: biostudies-literature