@article {Alvese2114作者={弗朗西斯卡阿尔维斯和Pawel Kalinowski斯科特Ayton}, title ={加速脑容量损失引起的反{\ textendash}β-Amyloid药物},体积={100}={20},页面= {e2114——e2124} = {2023}, doi = {10.1212 / WNL。出版商0000000000207156}= {Wolters Kluwer健康,公司代表美国神经病学学会},文摘={背景和目标来评估大脑体积变化引起的不同的子类反{\ textendash}β-半岛投注体育官网amyloid (Aβ)落后于阿尔茨海默病病人的药物。方法PubMed、Embase和ClinicalTrials.gov数据库寻找anti-Aβ药物的临床试验。这个系统回顾和荟萃分析包括成年人参加anti-Aβ药物的随机对照试验(n = 8062 {\ textendash} 10279)。入选标准如下:(1)患者的随机对照试验anti-Aβ药物有利变化了至少一个生物标志物的病理Aβ和(2)详细的核磁共振数据足以评估至少一个大脑区域的体积变化。MRI脑容量被用作主要的结果测量;大脑区域通常报道包括海马、侧脑室,整个大脑。阿里亚斯Amyloid-related成像异常()在临床试验报告时进行调查。145年的试验了,31日包含在最终的分析。荟萃分析的最高剂量的每个试验的结果在海马体,心室,整个大脑显示药物引起的体积变化多样的加速度anti-Aβ药品类。分泌酶抑制剂加速萎缩海马体(Δ安慰剂-Δ药物:-37.1 {\ textmu} L(19.6 \ %超过安慰剂); 95\% CI -47.0 to -27.1) and whole brain (Δ placebo - Δ drug: -3.3 mL [21.8\% more than placebo]; 95\% CI -4.1 to 2.5). Conversely, ARIA-inducing monoclonal antibodies accelerated ventricular enlargement (Δ placebo - Δ drug: +2.1 mL [38.7\% more than placebo]; 95\% CI 1.5{\textendash}2.8) where a striking correlation between ventricular volume and ARIA frequency was observed (r = 0.86, p = 6.22 {\texttimes} 10-7). Mild cognitively impaired participants treated with anti-Aβ drugs were projected to have a material regression toward brain volumes typical of Alzheimer dementia \~{}8 months earlier than if they were untreated.Discussion These findings reveal the potential for anti-Aβ therapies to compromise long-term brain health by accelerating brain atrophy and provide new insight into the adverse impact of ARIA. Six recommendations emerge from these findings.Aβ=β-amyloid; ARIA=amyloid-related imaging abnormality; ARIA-E=ARIA edema; ARIA-H=ARIA hemorrhagic; FDA=Food and Drug Administration; IVIg=IV immunoglobulin; LTP=long-term potentiation; MCI=mild cognitive impairment; PIB=Pittsburgh compound B; PRISMA=Preferred Reporting Items for Systematic Reviews and Meta-Analyses; SUVR=standardized uptake value ratio}, issn = {0028-3878}, URL = {//www.ebmtp.com/content/100/20/e2114}, eprint = {//www.ebmtp.com/content/100/20/e2114.full.pdf}, journal = {Neurology} }