Neuropsychological, neuropsychiatric, and quality-of-life assessments in Alzheimer's disease patients treated with plasma exchange with albumin replacement from the randomized AMBAR study

Research Center and Memory Clinic, Fundació ACE, Institut Català de Neurociències Aplicades-Universitat Internacional de Catalunya, Barcelona, Spain. Centro de Investigación Biomédica en Red de Enfermedades Neurodegenerativas (CIBERNED), Instituto de Salud Carlos III, Madrid, Spain. Departments of Neurology and Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA. Neurology Service, Hospital General Universitario Gregorio Marañón, Madrid, Spain. Memory Disorders Clinic, HM Hospitales, Madrid, Spain. Alzheimer's Research Group, Grifols, Barcelona, Spain. Medical Services, Allied Biomedical Research Institute, Inc., Miami, Florida, USA. Center for Prevention of Alzheimer's Disease, Miami Dade Medical Research Institute, Miami, Florida, USA. Cognitive Disorders Unit, Clinical Neuroscience Research, IRB Lleida-Hospital Universitari Santa Maria, Lleida, Spain. Psychiatry Department, Galiz Research, Hialeah, Florida, USA. Nephrology Service, Hospital General Universitario Gregorio Marañón, Madrid, Spain. Apheresis Care Group and Fresenius Medical Care, San Francisco, California, USA. Department of Pathology and Laboratory Medicine, Dartmouth Hitchcock Medical Center, Lebanon, New Hampshire, USA. Institute of Hematology and Transfusion Medicine, Warsaw, Poland.

Alzheimer's & dementia : the journal of the Alzheimer's Association. 2021
INTRODUCTION We report the effects of plasma exchange (PE) with albumin replacement on neuropsychological, neuropsychiatric, and quality-of-life (QoL) outcomes in mild-to-moderate Alzheimer's disease (AD) patients in a phase 2b/3 trial (Alzheimer's Management by Albumin Replacement [AMBAR] study). METHODS Three hundred forty-seven patients were randomized into placebo (sham-PE) and three PE-treatment arms with low/high doses of albumin, with/without intravenous immunoglobulin (IVIG). Specific test measurements were performed at baseline; month 2 (weekly conventional PE); months 6, 9, and 12 (monthly low-volume PE [LVPE]); and month 14. RESULTS The PE-treated mild-AD cohort improved their language fluency and processing speed versus placebo at month 14 (effect sizes: >100%; P-values: .03 to .001). The moderate-AD cohort significantly improved short-term verbal memory (effect sizes: 94% to >100%; P-values: .02 to .003). The progression of the neuropsychiatric symptoms of PE-treated was similar to placebo. Mild-AD patients showed improved QoL (P-values: .04 to .008). DISCUSSION PE-treated AD patients showed improvement in memory, language abilities, processing speed, and QoL-AD. No worsening of their psychoaffective status was observed.
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Language : eng
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