681. Oral iptacopan therapy in patients with C3 glomerulopathy: a randomised, double-blind, parallel group, multicentre, placebo-controlled, phase 3 study.
作者: David Kavanagh.;Andrew S Bomback.;Marina Vivarelli.;Carla M Nester.;Giuseppe Remuzzi.;Ming-Hui Zhao.;Edwin K S Wong.;Yaqin Wang.;Induja Krishnan.;Imelda Schuhmann.;Angelo J Trapani.;Nicholas J A Webb.;Matthias Meier.;Rubeen K Israni.;Richard J H Smith.; .
来源: Lancet. 2025年406卷10512期1587-1598页
C3 glomerulopathy is an ultra-rare, severe form of glomerulonephritis caused by overactivation of the alternative complement pathway. We aimed to assess efficacy and safety of iptacopan (LNP023), an oral, proximal complement inhibitor that targets factor B to selectively inhibit the alternative pathway of the complement cascade.
697. The global, regional, and national burden of cancer, 1990-2023, with forecasts to 2050: a systematic analysis for the Global Burden of Disease Study 2023.
Cancer is a leading cause of death globally. Accurate cancer burden information is crucial for policy planning, but many countries do not have up-to-date cancer surveillance data. To inform global cancer-control efforts, we used the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2023 framework to generate and analyse estimates of cancer burden for 47 cancer types or groupings by age, sex, and 204 countries and territories from 1990 to 2023, cancer burden attributable to selected risk factors from 1990 to 2023, and forecasted cancer burden up to 2050.
699. Alzheimer's disease outlook: controversies and future directions.
作者: Giovanni B Frisoni.;Emil Aho.;Carol Brayne.;Olga Ciccarelli.;Bruno Dubois.;Nick C Fox.;Kristian S Frederiksen.;Cem Gabay.;Valentina Garibotto.;Thomas Hofmarcher.;Clifford R Jack.;Miia Kivipelto.;Ronald C Petersen.;Federica Ribaldi.;Christopher C Rowe.;Sebastian Walsh.;Henrik Zetterberg.;Oskar Hansson.
来源: Lancet. 2025年406卷10510期1424-1442页
For the first time, reductions in cerebral β-amyloid pathology load and rate of cognitive and functional decline have been achieved in Alzheimer's disease, through pharmacological intervention in randomised controlled trials. However, the results from phase 3 randomised controlled trials of anti-β amyloid monoclonal antibodies are interpreted in different ways, with some experts supporting a clinically meaningful disease-modifying effect, and others judging insufficient benefit-to-risk ratio and opposing market authorisation. In the final paper of this Series, we discuss these contrasting views, all of which wish to contribute to improvements in the quality of life of people with, or at risk of, Alzheimer's disease. We contrast the efficacy, societal costs, and generalisability of monoclonal antibodies for Alzheimer's disease to biologics for other conditions (eg, cancer, multiple sclerosis, and rheumatoid arthritis) and set this debate in the larger context of modern personalised medicine. We discuss current practice implications, future developments directed to β-amyloid and non-amyloid targets that might have more clinical efficacy and less adverse effects for those with the disease, and large-scale prevention interventions for those at risk.
700. Treatment for Alzheimer's disease.
作者: Nick C Fox.;Christopher Belder.;Clive Ballard.;Helen C Kales.;Catherine Mummery.;Paulo Caramelli.;Olga Ciccarelli.;Kristian S Frederiksen.;Teresa Gomez-Isla.;Zahinoor Ismail.;Claire Paquet.;Ronald C Petersen.;Robert Perneczky.;Louise Robinson.;Ozge Sayin.;Giovanni B Frisoni.
来源: Lancet. 2025年406卷10510期1408-1423页
Over the last three decades, the evidence on how to best treat the cognitive and non-cognitive symptoms of patients with Alzheimer's disease has increased. Although these pharmacological and non-pharmacological strategies have significantly improved health outcomes for patients with Alzheimer's disease, many lack stringent evidence of efficacy. In this second paper of the Series, we provide practical and realistic advice on how to prioritise pharmacological and non-pharmacological strategies to ameliorate cognitive impairment and behavioural and psychological symptoms of dementia. In this clinical environment, dementia specialists are faced with the challenge of holistically integrating the much anticipated and, in some respects, controversial anti-β amyloid monoclonal antibodies. Here, we present the current approval scenario of monoclonal antibodies, our view on how they might further contribute to improve patients' quality of life, and how they could be seamlessly integrated with existing best care options.
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