Det var mycket intressant läsning. I tabelen på länken nedan ser man head-to-head jämförelse av de 4 kandidater som avhandlas i studien och det är ganska tydligt att BAN2401 är överlägsen.https://alzres.biomedcentral.com/articles/10.1186/s13195-020-00663-w/tables/1
Considering that no titration period is included in the CLARITY AD trial, the onset of clinical efficacy may occur earlier with BAN2401 than aducanumab.
Higher brain penetration of aducanumab versus BAN2401 does not appear to translate to better efficacy of aducanumab, suggesting that the superior selectivity for oligomers of BAN2401 is a key factor. In addition, the total dose of BAN2401 at the phase 2 and 3 dosing regimens is approximately double that of aducanumab, which may explain some of the efficacy differences.
The risk of ARIA-E is especially important in APOE4 carriers who carry a higher burden of vascular amyloid. The high ARIA-E rates of aducanumab (35%) and gantenerumab (28–42%), and the lower rate of BAN2401 (10%) in the overall population, parallel their affinity for amyloid plaque binding, and the degree of selectivity for soluble oligomers versus insoluble plaques.
Due to the rapid removal of amyloid plaque deposits from brain vessels, treatment with antibodies aducanumab, gantenerumab, and BAN2401 is associated with a substantial risk of ARIA-E in APOE4 carriers. While the efficacy of aducanumab in APOE4 carriers has not yet been disclosed, the incidence of ARIA-E in APOE4 carriers was ~ 42% in this group versus ~ 35% in the overall population [11, 19]. BAN2401 showed more robust clinical efficacy in APOE4 carriers ; however, this was associated with a higher incidence of ARIA-E of ~ 15% versus 10% in the overall study population.