Mercè Boada, MD, PhD, Fundació ACE, International University of Catalonia, Barcelona, Spain, outlines the details of the Phase IIb/III randomized, placebo-controlled AMBAR study investigating the safety and efficacy of therapeutic plasma exchange (TPE) with albumin replacement in patients with mild/moderate Alzheimer’s disease. A total of 347 patients were randomized into four arms: one arm underwent a sham procedure and the other three arms received TPE with different replacement volumes of therapeutic albumin, with or without intravenous immunoglobulin. An initial 6-week intensive phase of weekly total plasma exchange was followed by a low volume exchange maintenance phase. At 14 months, Alzheimer’s Disease Cooperative Study–Activities of Daily Living (ADCS-ADL) scores showed 52% less decline in the treatment arms compared to placebo. Additionally, Alzheimer’s Disease Assessment Scale-Cognitive Subscale (ADAS-Cog) scores showed a 66% reduction in decline compared to placebo. Global endpoints were assessed via the Clinical Dementia Rating Sum of Boxes (CDR-sb) and Alzheimer’s Disease Cooperative Study-Clinical Global Impression of Change (ADCS-CGIC) scales. All patients treated with TPE showed statistically significant differences in these measures compared to placebo. This interview took place during the European Academy of Neurology 2021 congress.
