Vandenberghe, RikRiviere, Marie-EmmanuelleCaputo, AngelikaSovago, JuditMaguire, R. PaulFarlow, MartinMarotta, GiovanniSanchez-Valle, RaquelScheltens, PhilipRyan, J. MichaelGraf, Ana2017-10-272017-10-272017-01Vandenberghe, R., Riviere, M. E., Caputo, A., Sovago, J., Maguire, R. P., Farlow, M., ... & Graf, A. (2017). Active Aβ immunotherapy CAD106 in Alzheimer's disease: A phase 2b study. Alzheimer's & Dementia: Translational Research & Clinical Interventions, 3(1), 10-22. https://doi.org/10.1016/j.trci.2016.12.003https://hdl.handle.net/1805/14396Introduction This randomized, double-blind, placebo-controlled, 90-week study assessed safety, tolerability, and immunogenicity of CAD106 with/without adjuvant in patients with mild Alzheimer's disease. Methods One hundred twenty-one patients received up to seven intramuscular injections of CAD106 (150 μg or 450 μg) or placebo ± adjuvant over 60 weeks. An amyloid positron emission tomography (PET) substudy was also conducted. Results CAD106 induced strong serological responses (amyloid-beta [Aβ]–Immunoglobuline G[IgG]) in 55.1% (150 μg) and 81.1% (450 μg) of patients (strong serological responders [SSRs]). Serious adverse events (SAEs) were reported in 24.5% (95% confidence interval [CI] 16.7–33.8) of the patients in the active treatment group and in 6.7% (95% CI 0.2–31.9) in the placebo group. Three of the SAEs were classified as possibly related to study drug by the investigators. No evidence of central nervous system inflammation was found. Amyloid-related imaging abnormalities (ARIAs) occurred in six cases, all of them were strong serological responders. None of the ARIAs were symptomatic. Serum Aβ-IgG titer area under the curves correlated negatively with amyloid PET standardized uptake value ratio percentage change from baseline to week 78 within the CAD106-treated patients (r = −0.84, P = .0004). Decrease in cortical gray-matter volume from baseline to week 78 was larger in SSRs than in controls (P = .0077). Discussion Repeated CAD106 administration was generally well tolerated. CAD106 450 μg with alum adjuvant demonstrated the best balance between antibody response and tolerability.enAttribution-NonCommercial-NoDerivs 3.0 United StatesAlzheimer's DiseaseCAD106active immunotherapyArticle