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Review
. 2010 Jul;10(7):1121-30.
doi: 10.1517/14712598.2010.493872.

Bapineuzumab

Geoffrey A Kerchner  1 , Adam L Boxer
Affiliations
Review

Bapineuzumab

Geoffrey A Kerchner et al. Expert Opin Biol Ther. 2010 Jul.

Abstract

Importance of the field: Alzheimer's disease is the leading cause of dementia in the elderly, and there is no disease-modifying therapy yet available. Immunotherapy directed against the beta-amyloid peptide may be capable of slowing the rate of disease progression. Bapineuzumab, an anti-beta-amyloid monoclonal antibody, will be the first such agent to emerge from Phase III clinical trials.

Areas covered in this review: The primary literature on bapineuzumab from 2009 and 2010 is reviewed in its entirety, along with the literature on AN1792, a first-generation anti-beta-amyloid vaccine, from 2003 to 2009. Other Alzheimer's disease immunotherapeutics currently in development, according to www.clinicaltrials.gov , are also discussed.

What the reader will gain: In addition to a critical appraisal of the Phase II trial results for bapineuzumab, this review considers the broader field of immunotherapy for Alzheimer's disease as a whole, including the challenges ahead.

Take home message: Bapineuzumab appears capable of reducing the cerebral beta-amyloid peptide burden in patients with Alzheimer's disease. However, particularly in APOE 4 carriers, its ability to slow disease progression remains uncertain, and vasogenic edema - a dose-limiting and potentially severe adverse reaction - may limit its clinical applicability.

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References

    1. Salloway S, Sperling R, Gilman S, et al. A phase 2 multiple ascending dose trial of bapineuzumab in mild to moderate Alzheimer disease. Neurology. 2009;73(24):2061–2070. This is the main Phase II trial of bapineuzumab. - PMC - PubMed
    1. Blennow K, de Leon MJ, Zetterberg H. Alzheimer’s disease. The Lancet. 2006;368(9533):387–403. - PubMed
    1. Schenk D, Barbour R, Dunn W, et al. Immunization with amyloid-beta attenuates Alzheimer-disease-like pathology in the PDAPP mouse. Nature. 1999;400(6740):173–177. This is the first description of Aβ vaccination and plaque removal in a mouse model of AD, by the same group who went on to develop AN1792. - PubMed
    1. Janus C, Pearson J, McLaurin J, et al. A beta peptide immunization reduces behavioural impairment and plaques in a model of Alzheimer’s disease. Nature. 2000;408(6815):979–982. - PubMed
    1. Morgan D, Diamond DM, Gottschall PE, et al. A beta peptide vaccination prevents memory loss in an animal model of Alzheimer’s disease. Nature. 2000;408(6815):982–985. - PubMed

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